Provider Demographics
NPI:1699156570
Name:CONTRACTOR, KIRAN RASHMI (CAADC)
Entity type:Individual
Prefix:MR
First Name:KIRAN
Middle Name:RASHMI
Last Name:CONTRACTOR
Suffix:
Gender:M
Credentials:CAADC
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Mailing Address - Street 1:3600 MARKET ST
Mailing Address - Street 2:SUITE 601
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-3284
Mailing Address - Country:US
Mailing Address - Phone:267-341-1692
Mailing Address - Fax:267-433-2009
Practice Address - Street 1:3600 MARKET ST
Practice Address - Street 2:SUITE 601
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-3284
Practice Address - Country:US
Practice Address - Phone:267-341-1692
Practice Address - Fax:267-433-2009
Is Sole Proprietor?:No
Enumeration Date:2015-06-16
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PA9076101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA9076OtherPENNSYLVANIA