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General NPI Number Information
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NPI Number | 1295642460
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Entity Type | Individual
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Provider Name | ASHLEE LAUREN RADZIKOWSKI LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/25/2026
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Last Update Date | 08/25/2026
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Provider Practice Location Address
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Address Line | 218 S FRANCES ST
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City | SOUTH BEND
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State | IN
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Zip | 46617-3004
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Country | US
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Telephone | 574-221-0446
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Fax |
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Provider Business Mailing Address
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Address Line | 61969 OAK GROVE RD
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City | CASSOPOLIS
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State | MI
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Zip | 49031-9621
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Country | US
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Telephone | 574-354-2449
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Fax | 574-354-2449
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 34012769A
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License Number State | IN
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