Provider Demographics
NPI:1932974953
Name:RAMOUTAR, KAVITA SITARA (LCSWA)
Entity type:Individual
Prefix:
First Name:KAVITA
Middle Name:SITARA
Last Name:RAMOUTAR
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 DUNVEGAN DR
Mailing Address - Street 2:
Mailing Address - City:RAEFORD
Mailing Address - State:NC
Mailing Address - Zip Code:28376-9166
Mailing Address - Country:US
Mailing Address - Phone:910-391-9047
Mailing Address - Fax:
Practice Address - Street 1:753 S MAIN ST
Practice Address - Street 2:
Practice Address - City:RAEFORD
Practice Address - State:NC
Practice Address - Zip Code:28376-3238
Practice Address - Country:US
Practice Address - Phone:910-490-2037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-20
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC29638101YA0400X
NCP0199851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)