| Doctor Name: | MR. KENT PAUL RADWANI |
| NPI Number: | 1104902477 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW |
| License Number: | 0904002086 |
| Business Practice Address: | 9403 Pocohontas Trail Providence Forge, VA - 23140 |
| Business Phone Number: | 8049665959 |
| Business Fax Number: | |
| Mailing Address: | 10299 Woodman Rd, GLEN ALLEN |
| State: | VA |
| Postal Code: | 230604419 |
| Phone Number: | 8047278500 |
| Fax Number: | 8047278580 |
| NPI Enumeration Date: | 10/30/2006 |
| NPI Last Update Date: | 06/23/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 0904002086 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |