Provider Demographics
NPI:1134289150
Name:ENDRESS, ANNA (MSW,LCSW)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:ENDRESS
Suffix:
Gender:F
Credentials:MSW,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:ROSELLE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07204-1948
Mailing Address - Country:US
Mailing Address - Phone:908-241-4692
Mailing Address - Fax:908-241-0652
Practice Address - Street 1:331 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:ROSELLE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07204-1948
Practice Address - Country:US
Practice Address - Phone:908-241-4692
Practice Address - Fax:908-241-0652
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSC07539001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical