Provider Demographics
NPI:1356510044
Name:VERMA, ANJU (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:ANJU
Middle Name:
Last Name:VERMA
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 1:5720 CREEDMOOR RD
Mailing Address - Street 2:SUITE # 201
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-2256
Mailing Address - Country:US
Mailing Address - Phone:919-946-5852
Mailing Address - Fax:919-300-7471
Practice Address - Street 1:5720 CREEDMOOR RD
Practice Address - Street 2:SUITE # 201
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-2256
Practice Address - Country:US
Practice Address - Phone:919-946-5852
Practice Address - Fax:919-300-7471
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-27
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0049401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6106941Medicaid