Prama Chakravarti, PHD, HSPP

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

PY60465923 Issued in WA

Practice address

780 Swift Blvd
Richland, WA 99352

Phone

(509) 942-2028

Fax

(509) 942-3218

NPI assigned

Dec 6, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kadlec Regional Medical Center

  • General Acute Care Hospital
  • Richland, WA
  • NPI 1972507580
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1323129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423785600000",
    "number": "1447528369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 GAGE BLVD",
            "address_2": "SUITE 203",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993528650",
            "telephone_number": "509-942-3627",
            "fax_number": "509-942-2268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 SWIFT BLVD",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "99352",
            "telephone_number": "509-942-2028",
            "fax_number": "509-942-3218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAKRAVARTI",
        "first_name": "PRAMA",
        "credential": "PHD, HSPP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-06",
        "last_updated": "2015-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "IN",
            "license": "20042688A",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "WA",
            "license": "PY60465923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PY60465923",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sonia Marie Cearlock, M.S., CCC-SLP
• Bryce Tyler Cedarquist
• Olga Ines Cepeda, LANGUAGE INTERPRETER
• Susan L Cerrillo, PHARM.D.
• Miguel Cervantes III, M.D.
• Stacie Naseem Chance, FNP, ARNP
• Prem Chand, MD
• Teresa Chandler, RN
• Christy Maria Chantharath, ARNP
• Eunice Chappell

• Clinical Child & Adolescent Psychologist in Richland, WA
• Providers in Richland, WA by specialty
• Clinical Child & Adolescent Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.