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Organization
RADICALLYBLENDED SERVICES
Active
Organization
RADICALLYBLENDED SERVICES
Active
Other names
radicallyBLended Services
Organization subpart
No
Provider details
NPI number
Authorized official
KEISHA J WALKER MATHEW LCSW (OWNER)
(872) 763-4405
Entity
Organization
Contact information
Practice address
5113 S HARPER AVE STE 2C, CHICAGO, IL 60615-4119
(872) 763-4405
Mailing address
5113 S HARPER AVE STE 2C, CHICAGO, IL 60615-4119
(872) 763-4405
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
06/13/2024
Last updated
11/14/2024
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