Provider Demographics
NPI:1689001208
Name:RANER, SONDRA D (MSW, LCSW LAC)
Entity Type:Individual
Prefix:
First Name:SONDRA
Middle Name:D
Last Name:RANER
Suffix:
Gender:F
Credentials:MSW, LCSW LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7702 W 12TH ST
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-8864
Mailing Address - Country:US
Mailing Address - Phone:970-545-9133
Mailing Address - Fax:970-545-9133
Practice Address - Street 1:7702 W 12TH ST
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-8864
Practice Address - Country:US
Practice Address - Phone:970-545-9133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-27
Last Update Date:2021-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW-09924171101YM0800X
COCSW.099241711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO08724211Medicaid