Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Radicallyblended Services

Organization Clinical Social Worker · NPI 1932942497

Radicallyblended Services is a Clinical Social Worker in Chicago, Illinois. Registered with an NPI since 2024.

In the registry since
2024

Practice location Address checks out

5113 S Harper Ave Ste 2C
Chicago, IL 60615-4119
Phone: (872) 763-4405
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X

Record details

NPI number1932942497
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Keisha Walker Mathew — Owner · (872) 763-4405
Other names Radicallyblended Services
NPI enumeratedJune 13, 2024
Last updated in NPPESNovember 14, 2024
Certification dateNovember 14, 2024
Mailing address5113 S Harper Ave Ste 2c, Chicago, IL 60615-4119

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