Provider Demographics
NPI:1457876294
Name:VEENA RAGHUVIR LCSW, LLC
Entity Type:Organization
Organization Name:VEENA RAGHUVIR LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:VEENA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAGHUVIR
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:203-535-9696
Mailing Address - Street 1:31 NORTHGATE
Mailing Address - Street 2:
Mailing Address - City:SIMSBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06070-1032
Mailing Address - Country:US
Mailing Address - Phone:203-535-9696
Mailing Address - Fax:
Practice Address - Street 1:760 HOPMEADOW ST
Practice Address - Street 2:
Practice Address - City:SIMSBURY
Practice Address - State:CT
Practice Address - Zip Code:06070-2257
Practice Address - Country:US
Practice Address - Phone:203-535-9696
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-12
Last Update Date:2017-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT57911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty