Provider Demographics
NPI:1194912311
Name:KANDHARI, RAVLEEN KAUR (LCSW)
Entity type:Individual
Prefix:MS
First Name:RAVLEEN
Middle Name:KAUR
Last Name:KANDHARI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6123 MONTROSE RD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4860
Mailing Address - Country:US
Mailing Address - Phone:301-881-3700
Mailing Address - Fax:301-770-0901
Practice Address - Street 1:3018 JAVIER RD
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4609
Practice Address - Country:US
Practice Address - Phone:703-204-3100
Practice Address - Fax:703-204-9590
Is Sole Proprietor?:No
Enumeration Date:2007-10-02
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904006671104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker