DR. MANJU PRADHAN (NPI# 1720122120) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720122120 |
| Entity Type | Individual |
| Full Name | DR. MANJU PRADHAN |
| Credential | PHD |
| Practice Address |
1129 Macklind Ave Saint Louis MO 63110-1440 |
| Practice Telephone | 3145340200 |
| Practice Fax Number | 3145347996 |
| Mailing Telephone | 3145340200 |
| Mailing Fax Number | 3145347996 |
| Enumeration Date | 2007-02-18 |
| Last Update Date | 2009-07-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
2006033337 | MO | Behavioral Health & Social Service Providers |
| Y | 103TC1900X |
Psychologist Specialization: Counseling |
017882 | NY | Behavioral Health & Social Service Providers |
| Street Address |
1129 MACKLIND AVE |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63110-1440 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487732335 | St. Louis Behavioral Medicine Institute Inc | Psychologist | 1129 Macklind Ave, Saint Louis, MO 63110-1440 | 2006-11-01 |
| 1134746712 | Carolyn Lee | Psychologist | 1129 Macklind Ave, Saint Louis, MO 63110-1440 | 2020-06-30 |
| 1760034276 | Emily R Gorzalski | Psychologist | 1129 Macklind Ave, Saint Louis, MO 63110-1440 | 2019-07-15 |
| 1992213326 | Alison R Menatti | Psychologist | 1129 Macklind Ave, Saint Louis, MO 63110-1440 | 2018-01-19 |
| 1790237220 | Sandra Rose Price | Social Worker | 1129 Macklind Ave, Saint Louis, MO 63110-1440 | 2016-11-01 |
| 1295103216 | Jessica Polson | Psychologist | 1129 Macklind Ave, Saint Louis, MO 63110-1440 | 2015-09-08 |
| 1841667029 | Kaylie Thomas Allen | Psychologist | 1129 Macklind Ave, Saint Louis, MO 63110 | 2015-08-24 |
| 1770963407 | Jessica Gerfen | Psychologist | 1129 Macklind Ave, Saint Louis, MO 63110-1440 | 2015-06-08 |
| 1992114417 | Camille Randall | Psychologist | 1129 Macklind Ave, Saint Louis, MO 63110-1440 | 2014-08-08 |
| 1487093092 | Kerrie Armstrong | Psychologist | 1129 Macklind Ave, Saint Louis, MO 63110-1440 | 2013-06-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659971992 | Carrie Ellen Smith | Nurse Practitioner | Mailstop 90-00-174, One Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-10-27 |
| 1881210466 | Michelle Amanda Freilich | Internal Medicine | Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-06-19 |
| 1245856046 | Jeevin Shahi | Radiology | 3685 Vista Avenue, Center for Radiation Medicine, St. Louis, MO 63110 | 2020-06-18 |
| 1497371314 | Wilson Eduardo Rodriguez | Student in an Organized Health Care Education/Training Program | 1008 S. Spring, St Louis, MO 63110 | 2020-06-17 |
| 1578184065 | Kathryn Kay Lindsay | Registered Nurse | Saint Louis University Dept of Surgery, 3635 Vista Ave 3dt, St Louis, MO 63110 | 2020-05-06 |
| 1881232700 | Ashley Diane Pace | Nurse Practitioner | 1 Parkview Place, Shoenberg 6900, St. Louis, MO 63110 | 2019-12-11 |
| 1619520418 | Krithika Damodar Shenoy | Pathology | 660 Euclid Avenue, One Barnes Jewish Hospital Plaza, St. Louis, MO 63110 | 2019-07-20 |
| 1467912550 | Ian Ferguson | Dermatology | 660 S Euclid Ave., Cb 8123, St. Louis, MO 63110 | 2019-03-23 |
| 1760978688 | Ihab Hassanieh | Student in an Organized Health Care Education/Training Program | 33660 Vista Ave, St. Louis, MO 63110 | 2018-07-03 |
| 1336634500 | Martin K Mwangi | Pediatrics | 1 Childrens Place, 3s34, St. Louis, M, MO 63110 | 2018-06-28 |
| Find all providers in zip 63110 | ||||
| Taxonomy Code | 103TC1900X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Counseling |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063972081 | Marianela Dornhecker | Psychologist | 3832 Mcdonald Ave, Saint Louis, MO 63116-4717 | 2019-03-25 |
| 1518483825 | Consuelo Maturana | Psychologist | 7505 Pershing Ave Apt 2w, Saint Louis, MO 63130-4024 | 2017-08-17 |
| 1922520394 | Ivorie D Chambers | Psychologist | 10439 Gardo Court, Saint Louis, MO 63137 | 2017-07-07 |
| 1194140756 | Emergence Psychological Services | Psychologist | 1131 Thornwood Dr, Saint Louis, MO 63124-1227 | 2014-02-19 |
| 1952600983 | Chad John Keller | Psychologist | 7700 Clayton Rd Ste 103, Saint Louis, MO 63117-1345 | 2011-03-16 |
| 1356550289 | Indvidualized Therapy & Care, P.C. | Psychologist | 5858 White Pine Dr, Saint Louis, MO 63129-2954 | 2007-05-21 |
| 1942358049 | Sujatha Ramesh | Psychologist | 7750 Clayton Rd Ste 204, Saint Louis, MO 63117-1342 | 2007-01-08 |
| 1417493677 | Pallavi Mishra Nishith | Psychologist | 4130 Lindell Blvd, Saint Louis, MO 63108-2914 | 2017-01-12 |
| 1164971396 | April Reupke | Psychologist | 12837 Flushing Meadows Dr, Saint Louis, MO 63131-1824 | 2016-09-29 |
| 1609322510 | James Malen | Psychologist | 11960 Westline Industrial Dr, Suite 201, Saint Louis, MO 63146-3209 | 2016-08-30 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63110 |
Please comment or provide details below to improve the information on DR. MANJU PRADHAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.