Provider Demographics
NPI:1023387016
Name:DEC, ANNA (CASAC)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:DEC
Suffix:
Gender:F
Credentials:CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6801 FRESH POND RD
Mailing Address - Street 2:APT.2F
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11385-5233
Mailing Address - Country:US
Mailing Address - Phone:017-600-2158
Mailing Address - Fax:
Practice Address - Street 1:6801 FRESH POND RD
Practice Address - Street 2:APT.2F
Practice Address - City:RIDGEWOOD
Practice Address - State:NY
Practice Address - Zip Code:11385-5233
Practice Address - Country:US
Practice Address - Phone:917-600-2158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-20
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)