Healthcare Provider Details

I. General information

NPI: 1316749930
Provider Name (Legal Business Name): PROSOCIAL WORK PSYCHOTHERAPY SERVICES P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2025
Last Update Date: 02/02/2026
Certification Date: 02/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1128 E CASTLE ROCK RD
SANDY UT
84094-5689
US

IV. Provider business mailing address

1128 E CASTLE ROCK RD
SANDY UT
84094-5689
US

V. Phone/Fax

Practice location:
  • Phone: 323-205-6524
  • Fax:
Mailing address:
  • Phone: 323-205-6524
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: VERONICA RANIWALA
Title or Position: PRESIDENT
Credential: LCSW
Phone: 323-205-6524