Provider Demographics
NPI:1497380653
Name:BHANDARI, SHREYA S (MSW, LSW, PHD)
Entity Type:Individual
Prefix:
First Name:SHREYA
Middle Name:S
Last Name:BHANDARI
Suffix:
Gender:F
Credentials:MSW, LSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6671 BLUEGRASS WAY
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-2499
Mailing Address - Country:US
Mailing Address - Phone:573-823-7609
Mailing Address - Fax:
Practice Address - Street 1:7031 CORPORATE WAY STE 103
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-4262
Practice Address - Country:US
Practice Address - Phone:573-823-7609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-09
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.18028111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical