Provider Demographics
NPI:1144905845
Name:PANCHANANAM, SIRI PRIYA (LPC)
Entity type:Individual
Prefix:
First Name:SIRI
Middle Name:PRIYA
Last Name:PANCHANANAM
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10947 REEDER ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-1366
Mailing Address - Country:US
Mailing Address - Phone:913-653-3417
Mailing Address - Fax:
Practice Address - Street 1:10881 LOWELL AVE STE 130
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-1666
Practice Address - Country:US
Practice Address - Phone:913-386-6889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health