Provider Demographics
NPI:1033534888
Name:ANJOS, ENEIDA M (LICSW)
Entity Type:Individual
Prefix:MISS
First Name:ENEIDA
Middle Name:M
Last Name:ANJOS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 APPALOOSA WAY
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-7196
Mailing Address - Country:US
Mailing Address - Phone:617-230-3396
Mailing Address - Fax:
Practice Address - Street 1:167 APPALOOSA WAY
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-7196
Practice Address - Country:US
Practice Address - Phone:617-230-3396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-03
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA218087101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health