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General NPI Number Information
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NPI Number | 1649979378
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Entity Type | Individual
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Provider Name | KIANA LANAE' PRATT LCSW-A
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Gender | Female
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Dates
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Enumeration Date | 03/02/2023
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Last Update Date | 09/28/2023
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Provider Practice Location Address
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Address Line | 12141 OLD DULIN FARMS WAY
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City | CHARLOTTE
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State | NC
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Zip | 28215-5208
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Country | US
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Telephone | 860-778-5317
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Fax | 860-955-4453
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Provider Business Mailing Address
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Address Line | 4751 FORESTRIDGE COMMONS DR
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City | CHARLOTTE
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State | NC
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Zip | 28269-2095
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Country | US
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Telephone | 336-552-7317
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | P017414
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License Number State | NC
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