Provider Demographics
NPI:1144694506
Name:RATKALKAR, MINAKSHI (PHD, LCSW, CST)
Entity type:Individual
Prefix:
First Name:MINAKSHI
Middle Name:
Last Name:RATKALKAR
Suffix:
Gender:F
Credentials:PHD, LCSW, CST
Other - Prefix:
Other - First Name:MINA
Other - Middle Name:
Other - Last Name:RATKALKAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6409 FAYETTEVILLE RD STE 120-189
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-6297
Mailing Address - Country:US
Mailing Address - Phone:215-882-9949
Mailing Address - Fax:
Practice Address - Street 1:6409 FAYETTEVILLE RD STE 120-189
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-6297
Practice Address - Country:US
Practice Address - Phone:215-882-9949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-23
Last Update Date:2021-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 124241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical