Provider Demographics
NPI:1942173786
Name:RADICAL CONNECTION LLC
Entity type:Organization
Organization Name:RADICAL CONNECTION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:AUDRA
Authorized Official - Middle Name:TAYLOR
Authorized Official - Last Name:WINN
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:413-281-9245
Mailing Address - Street 1:25 GREGORY LN
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01062-3455
Mailing Address - Country:US
Mailing Address - Phone:413-281-9245
Mailing Address - Fax:
Practice Address - Street 1:25 GREGORY LN
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01062-3455
Practice Address - Country:US
Practice Address - Phone:413-281-9245
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-26
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty