Provider Demographics
NPI:1982763173
Name:RADOV, BARBARA ELLEN (MSW)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ELLEN
Last Name:RADOV
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 GLENWOOD ST
Mailing Address - Street 2:SUITE #315
Mailing Address - City:SHAWNEE MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66202-4016
Mailing Address - Country:US
Mailing Address - Phone:913-677-5255
Mailing Address - Fax:913-677-5250
Practice Address - Street 1:6400 GLENWOOD ST
Practice Address - Street 2:SUITE #315
Practice Address - City:SHAWNEE MISSION
Practice Address - State:KS
Practice Address - Zip Code:66202-4016
Practice Address - Country:US
Practice Address - Phone:913-677-5255
Practice Address - Fax:913-677-5250
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS06571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical