RADICAL LIFE CHANGES LLC
NPI 1295681682
Social Worker - Clinical in Waldorf, MD

Active since March 07, 2026
11777 NATIONALS LN, WALDORF, MD 20602(301) 456-5058 Get Directions Write a Review

NPPES record last updated: March 7, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Radical Life Changes Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RADICAL LIFE CHANGES LLC (NPI 1295681682) is a healthcare organization registered as a clinical in Waldorf, Maryland and active in the NPI registry since March 2026. The organization lists Valencia Bonner Lewis, Director, as its authorized official.

NPPES Registry Identity

NPI1295681682
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameRADICAL LIFE CHANGES LLC
Location Address11777 NATIONALS LNWaldorf, MD 20602-3274
Mailing Address11777 Nationals LnWaldorf, MD 20602-3274 · (301) 456-5058
Organization SubpartNo
Authorized OfficialValencia Bonner LewisDirector · (301) 456-5058
Enumeration DateMarch 7, 2026
NPPES CertifiedMarch 7, 2026
NPI 1295681682 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
11777 NATIONALS LN, Waldorf, MD 20602

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Radical Life Changes LLC's NPI number?

The NPI number for Radical Life Changes LLC is 1295681682. It was assigned to this organization in the NPPES registry on March 7, 2026.

Where is Radical Life Changes LLC located?

Radical Life Changes LLC is located at 11777 Nationals Ln, Waldorf, MD 20602. The listed phone number is (301) 456-5058.

What is Radical Life Changes LLC's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Radical Life Changes LLC was last updated on March 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.