Provider Demographics
NPI:1568706950
Name:VEGUNTA, SREE RAMANI (LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:SREE
Middle Name:RAMANI
Last Name:VEGUNTA
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 FRANKLIN TURNPIKE, #207
Mailing Address - Street 2:
Mailing Address - City:MAHWAH
Mailing Address - State:NJ
Mailing Address - Zip Code:07430-1363
Mailing Address - Country:US
Mailing Address - Phone:973-704-6876
Mailing Address - Fax:
Practice Address - Street 1:95 LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-5518
Practice Address - Country:US
Practice Address - Phone:973-704-6876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-26
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR047979-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical