Provider Demographics
NPI:1467859488
Name:RAJANI, RAVEN (LMSW)
Entity Type:Individual
Prefix:
First Name:RAVEN
Middle Name:
Last Name:RAJANI
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1102 W. 19TH TERR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66046
Mailing Address - Country:US
Mailing Address - Phone:785-979-7937
Mailing Address - Fax:
Practice Address - Street 1:1102 W 19TH TER
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66046-2616
Practice Address - Country:US
Practice Address - Phone:785-979-7937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-20
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KST-LMSW 9434104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker