Provider Demographics
NPI:1699098921
Name:RANAHAN, JAMES WILLIAM (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:WILLIAM
Last Name:RANAHAN
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13225 US HIGHWAY 1
Mailing Address - Street 2:A12
Mailing Address - City:SEBASTIAN
Mailing Address - State:FL
Mailing Address - Zip Code:32958-3747
Mailing Address - Country:US
Mailing Address - Phone:772-766-9152
Mailing Address - Fax:
Practice Address - Street 1:13225 US HIGHWAY 1
Practice Address - Street 2:A12
Practice Address - City:SEBASTIAN
Practice Address - State:FL
Practice Address - Zip Code:32958-3747
Practice Address - Country:US
Practice Address - Phone:772-766-9152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-01
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW90801041C0700X
MA10262121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical