Provider Demographics
NPI:1063844975
Name:VASWANI, VISHAL VIJAY (LMHC)
Entity Type:Individual
Prefix:MR
First Name:VISHAL
Middle Name:VIJAY
Last Name:VASWANI
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2855 TELEGRAPH AVE STE 515
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-1151
Mailing Address - Country:US
Mailing Address - Phone:510-345-4379
Mailing Address - Fax:
Practice Address - Street 1:2855 TELEGRAPH AVE STE 515
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-1151
Practice Address - Country:US
Practice Address - Phone:510-345-4379
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-01
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009694101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health