Provider Demographics
NPI:1083316269
Name:SHANER, ANNE M (LCSW)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:M
Last Name:SHANER
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 1:664 BALTIC ST APT 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-4565
Mailing Address - Country:US
Mailing Address - Phone:917-568-0793
Mailing Address - Fax:
Practice Address - Street 1:664 BALTIC ST APT 1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-4565
Practice Address - Country:US
Practice Address - Phone:917-568-0793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0911511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical