Individual
KILEY S RADICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LICSWA
Contact information
Practice address
748 14TH AVE, LONGVIEW, WA 98632-2315
(360) 200-5419
(360) 200-6736
Mailing address
PO BOX 2394, LONGVIEW, WA 98632-8455
(360) 200-5419
(360) 200-6736
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CG61169626
WA
104100000X
Social Worker
Primary
SC70074609
WA
1041C0700X
Clinical Social Worker
SC70074609
WA
171M00000X
Case Manager/Care Coordinator
Primary
CG61169626
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2178067
—
WA
Enumeration date
04/16/2021
Last updated
03/17/2026
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