Provider Demographics
NPI:1659147361
Name:RAMAKRISHNA, NANDINI (PHD)
Entity Type:Individual
Prefix:
First Name:NANDINI
Middle Name:
Last Name:RAMAKRISHNA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5124 E JUNIPER AVE
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-1067
Mailing Address - Country:US
Mailing Address - Phone:480-849-6132
Mailing Address - Fax:
Practice Address - Street 1:7220 N 16TH ST STE 1
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-5253
Practice Address - Country:US
Practice Address - Phone:602-824-8804
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-20521101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health