Provider Demographics
NPI:1407193733
Name:RANGARI, PRAMANAND SHALIKRAM (MSW)
Entity Type:Individual
Prefix:
First Name:PRAMANAND
Middle Name:SHALIKRAM
Last Name:RANGARI
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 BARING ST APT 2F
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-5113
Mailing Address - Country:US
Mailing Address - Phone:267-324-6690
Mailing Address - Fax:484-469-4307
Practice Address - Street 1:3801 BARING ST APT 2F
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-5113
Practice Address - Country:US
Practice Address - Phone:267-324-6690
Practice Address - Fax:484-469-4307
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health