Provider Demographics
NPI:1154501112
Name:ANDERSON, ANITA E (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:ANITA
Middle Name:E
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MISS
Other - First Name:ANITA
Other - Middle Name:E
Other - Last Name:JANNEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:1462 ERIE BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12305-1026
Mailing Address - Country:US
Mailing Address - Phone:518-243-1500
Mailing Address - Fax:
Practice Address - Street 1:216 LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12305-2408
Practice Address - Country:US
Practice Address - Phone:518-243-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-07
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY057763104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker