Provider Demographics
NPI:1972032316
Name:RAVANI, NUTAN K (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:NUTAN
Middle Name:K
Last Name:RAVANI
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 HERITAGE VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-1744
Mailing Address - Country:US
Mailing Address - Phone:856-589-5797
Mailing Address - Fax:856-582-9440
Practice Address - Street 1:3 HERITAGE VALLEY DRIVE
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080
Practice Address - Country:US
Practice Address - Phone:856-589-5797
Practice Address - Fax:856-582-9440
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSC085771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty