Provider Demographics
NPI:1821624354
Name:RADIANT THERAPY, LLC
Entity Type:Organization
Organization Name:RADIANT THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANELLE
Authorized Official - Middle Name:M
Authorized Official - Last Name:WEATHER
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:443-741-2267
Mailing Address - Street 1:9666 HASTINGS DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-1915
Mailing Address - Country:US
Mailing Address - Phone:443-741-2267
Mailing Address - Fax:
Practice Address - Street 1:14201 LAUREL PARK DR STE 106
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5203
Practice Address - Country:US
Practice Address - Phone:443-741-2267
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-16
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty