MEDICARE: BRIANNA RADFORD MSW, LGSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	101Y00000X	Counselor	MN
2	101YM0800X	Mental Health Counselor	MN
3	104100000X	Social Worker	MN
4	1041C0700X	Clinical Social Worker	MN

General Provider Information

NPI Number	:	1538020722
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIANNA RADFORD MSW, LGSW

Provider Business Mailing Address
First Line	:	2421 CHICAGO AVE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55404-3845
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2421 CHICAGO AVE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55404-3845
Country	:	US
Telephone Number	:	612-217-2482
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/19/2025
Last Update Date	:	11/19/2025

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