Provider Demographics
NPI:1669154696
Name:RADAWIEC, EMILY (LGPC, CAC-AD)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:RADAWIEC
Suffix:
Gender:F
Credentials:LGPC, CAC-AD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:847 AMHERST LN
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21158-4350
Mailing Address - Country:US
Mailing Address - Phone:804-638-1937
Mailing Address - Fax:
Practice Address - Street 1:3000 MANCHESTER RD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:MD
Practice Address - Zip Code:21102-1850
Practice Address - Country:US
Practice Address - Phone:410-861-0066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health