Provider Demographics
NPI:1609682806
Name:MARINGANTI, UTKALA (LMFT-A)
Entity type:Individual
Prefix:
First Name:UTKALA
Middle Name:
Last Name:MARINGANTI
Suffix:
Gender:F
Credentials:LMFT-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2611 SUNSET VISTA CIR
Mailing Address - Street 2:
Mailing Address - City:SPICEWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:78669-2086
Mailing Address - Country:US
Mailing Address - Phone:650-309-2210
Mailing Address - Fax:
Practice Address - Street 1:311 RANCH ROAD 620 S STE 103
Practice Address - Street 2:
Practice Address - City:LAKEWAY
Practice Address - State:TX
Practice Address - Zip Code:78734-4747
Practice Address - Country:US
Practice Address - Phone:512-766-9911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-04
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX205322103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily