Healthcare Provider Details

I. General information

NPI: 1891999579
Provider Name (Legal Business Name): RANIA L KHALIL LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 FLATBUSH AVE BROOKLYN CENTER FOR PSYCHOTHERAPY
BROOKLYN NY
11217-2812
US

IV. Provider business mailing address

16 TIFFANY PL APT 3R
BROOKLYN NY
11231-2994
US

V. Phone/Fax

Practice location:
  • Phone: 718-622-2000
  • Fax:
Mailing address:
  • Phone: 718-724-4594
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP55968
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: