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Organization

RADICAL THERAPY PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RACHEL DZIABUDA LMSW (OWNER)
(616) 259-5148
Entity
Organization

Contact information

Practice address
800 MONROE AVE NW STE 314, GRAND RAPIDS, MI 49503-1451
(616) 481-1479
Mailing address
800 MONROE AVE NW STE 314, GRAND RAPIDS, MI 49503-1451

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
261QM0850X
Adult Mental Health Clinic/Center
Primary
261QM0855X
Adolescent and Children Mental Health Clinic/Center

Other

Enumeration date
02/04/2026
Last updated
04/27/2026
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