Provider Demographics
NPI:1871644609
Name:NAGIREDDY, CHANDRA SEKHAR (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHANDRA
Middle Name:SEKHAR
Last Name:NAGIREDDY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2130 ACADEMY CIR
Mailing Address - Street 2:SUITE B
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-1694
Mailing Address - Country:US
Mailing Address - Phone:719-761-4444
Mailing Address - Fax:719-550-4100
Practice Address - Street 1:2130 ACADEMY CIR
Practice Address - Street 2:SUITE B
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-1694
Practice Address - Country:US
Practice Address - Phone:719-761-4444
Practice Address - Fax:719-550-4100
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO450106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist