Healthcare Provider Details

I. General information

NPI: 1326798406
Provider Name (Legal Business Name): RADIANT PATH MENTAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2022
Last Update Date: 03/24/2022
Certification Date: 03/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 DELAWARE ST
HISTORIC NEW CASTLE DE
19720-4814
US

IV. Provider business mailing address

609 W 3RD ST
WILMINGTON DE
19801-2321
US

V. Phone/Fax

Practice location:
  • Phone: 302-584-6960
  • Fax:
Mailing address:
  • Phone: 302-584-6960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: LAUREN BARILE
Title or Position: LCSW
Credential: LCSW
Phone: 302-584-6960