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General NPI Number Information
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NPI Number | 1689191850
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Entity Type | Individual
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Provider Name | PRARTHANA KHULLAR LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/28/2017
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Last Update Date | 12/20/2022
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Provider Practice Location Address
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Address Line | 630 W 168TH ST
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City | NEW YORK
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State | NY
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Zip | 10032-3725
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Country | US
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Telephone | 929-459-4034
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Fax |
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Provider Business Mailing Address
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Address Line | 2580 AMSTERDAM AVE
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City | NEW YORK
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State | NY
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Zip | 10040-3461
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Country | US
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Telephone | 217-816-9227
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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 | 58.011225
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149018869
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 091248
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License Number State | NY
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