Kenneth Wibowo Pranoto

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

108149 Issued in TX

Practice address

2425 Holly Hall St Apt A4
Houston, TX 77054-3930

Phone

(832) 409-8767

NPI assigned

Mar 18, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1710720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1619736071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 HOLLY HALL ST APT A4",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770543930",
            "telephone_number": "832-409-8767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 HOLLY HALL ST APT A4",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770543930",
            "telephone_number": "832-409-8767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRANOTO",
        "first_name": "KENNETH",
        "middle_name": "WIBOWO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-18",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "108149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Klein Pramudji, M.D.
• Pranami LLC
• Felicia Pranata, D.D.S.
• Bryan Thomas Prange, M.D.
• Robert Edwin Prangle, DO
• Sara Pranoto, RD, CSP, LD
• Savannah Rae Prantil, AGACNP-BC
• Shaizeel Praptani, M.D.
• Prasad Counseling and Training
• Aksa Prasad, PA-C

• Mental Health Counselor in Houston, TX
• Providers in Houston, TX by specialty
• Mental Health Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; 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.