Individual provider · Type 1 NPI

Brian Charles Radzom, LCSW

Clinical Social Worker · Edwardsville, IL

NPI number 1790941300 Active

Practice location

205 S Main St
Edwardsville, IL 62025-1921

Call (618) 248-2040 Map

Fax (618) 248-2040

Mailing address

PO Box 101
Edwardsville, IL 62025-0101

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X149012706 (IL)
Clinical Social Worker 1041C0700X2007033648 (MO)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1790941300

Brian Charles Radzom, LCSW's National Provider Identifier is 1790941300, issued on Aug 3, 2008. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Edwardsville, IL. The record was last updated on Oct 21, 2016.