Provider Demographics
NPI:1447925953
Name:KHARA, RADHIKA (LCSW)
Entity type:Individual
Prefix:
First Name:RADHIKA
Middle Name:
Last Name:KHARA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9631 COVEY RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-5818
Mailing Address - Country:US
Mailing Address - Phone:512-748-6127
Mailing Address - Fax:
Practice Address - Street 1:8500 N MOPAC EXPY STE 604
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8347
Practice Address - Country:US
Practice Address - Phone:512-350-6236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-16
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX552911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical