Provider Demographics
NPI:1275607806
Name:HOODEM, ANNA LEE (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:ANNA LEE
Middle Name:
Last Name:HOODEM
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3621 ORDWAY STREET NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016
Mailing Address - Country:US
Mailing Address - Phone:202-320-1936
Mailing Address - Fax:
Practice Address - Street 1:7910 WOODMONT AVE
Practice Address - Street 2:SUITE 460
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-3002
Practice Address - Country:US
Practice Address - Phone:301-656-9520
Practice Address - Fax:301-718-3633
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW012348L104100000X
MD123291041C0700X
DCLC500779591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDM578-0001OtherBCNCA CAREFIRST NATIONAL
MD3124758OtherMAMSI, MDIPA, OPTIMUM CHO
MD665777OtherNCPPO
MD2191786OtherCIGNA
MD330944OtherMHN TRICARE
MD594 BALOtherBCMD CAREFIRST MARYLAND
MDG01863A01Medicare ID - Type Unspecified