Provider Demographics
NPI:1033070529
Name:VIVEKANANDA, JANAKI
Entity type:Individual
Prefix:
First Name:JANAKI
Middle Name:
Last Name:VIVEKANANDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2446 DORCHESTER DR N APT 102
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-3752
Mailing Address - Country:US
Mailing Address - Phone:408-839-3474
Mailing Address - Fax:
Practice Address - Street 1:2446 DORCHESTER DR N APT 102
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-3752
Practice Address - Country:US
Practice Address - Phone:408-839-3474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-24
Last Update Date:2025-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011208091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty