Provider Demographics
NPI:1831754365
Name:CHIRUVOLU, VIKRAM SURYA (LGPC, MA, BSCS)
Entity type:Individual
Prefix:MR
First Name:VIKRAM
Middle Name:SURYA
Last Name:CHIRUVOLU
Suffix:
Gender:M
Credentials:LGPC, MA, BSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2032 BELMONT RD NW APT 312
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-5414
Mailing Address - Country:US
Mailing Address - Phone:202-250-1230
Mailing Address - Fax:
Practice Address - Street 1:2032 BELMONT RD NW APT 312
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-5414
Practice Address - Country:US
Practice Address - Phone:202-250-1230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-09
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLGPC00533103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCLGPC00533OtherDC BOARD OF HEALTH REGULATION & LICENSING