Neeraj Agrawal Clinic LTD

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2847125 Issued in WI

Legal business name

NEERAJ AGRAWAL CLINIC LTD

Practice address

7332 W State St # LL
Wauwatosa, WI 53213-2766

Phone

(414) 628-3457

Fax

(262) 252-4874

NPI assigned

Jul 15, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Neeraj B Agrawal, MA, SAC, LPCNPI 1649585324

Title

Director & Psychotherapist

Phone

(414) 628-3457

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• NEERAJ AGRAWAL Other name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Neeraj Agrawal, LPC, MA

  • Professional Counselor
  • Wauwatosa, WI
  • NPI 1649585324

  Addiction (Substance Use Disorder)

  NPD Authorized official

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282003200000",
    "number": "1891711222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11450 N CONCORD CREEK DR",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530924387",
            "telephone_number": "414-628-3457",
            "fax_number": "262-252-4874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7332 W STATE ST # LL",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532132766",
            "telephone_number": "414-628-3457",
            "fax_number": "262-252-4874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEERAJ AGRAWAL CLINIC LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2010-08-17",
        "status": "A",
        "authorized_official_last_name": "AGRAWAL",
        "authorized_official_first_name": "NEERAJ",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "DIRECTOR & PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "414-628-3457",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MA, SAC, LPC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "11544",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "2847125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43553100",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUEOPTIONS",
            "identifier": "242647",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NEERAJ AGRAWAL",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Professional Counselor in Wauwatosa, WI
• Providers in Wauwatosa, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2010; 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.