Provider Demographics
NPI:1649979378
Name:PRATT, KIANA LANAE' (LCSW-A)
Entity type:Individual
Prefix:
First Name:KIANA
Middle Name:LANAE'
Last Name:PRATT
Suffix:
Gender:F
Credentials:LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4751 FORESTRIDGE COMMONS DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-2095
Mailing Address - Country:US
Mailing Address - Phone:336-552-7317
Mailing Address - Fax:
Practice Address - Street 1:12141 OLD DULIN FARMS WAY
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-5208
Practice Address - Country:US
Practice Address - Phone:860-778-5317
Practice Address - Fax:860-955-4453
Is Sole Proprietor?:No
Enumeration Date:2023-03-02
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0174141041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical