Provider Demographics
NPI:1376722090
Name:MENDIZABAL, ANA MARIA (LCSW)
Entity Type:Individual
Prefix:
First Name:ANA MARIA
Middle Name:
Last Name:MENDIZABAL
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 1:138 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-4436
Mailing Address - Country:US
Mailing Address - Phone:401-475-4601
Mailing Address - Fax:
Practice Address - Street 1:181 CUMBERLAND ST
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-3301
Practice Address - Country:US
Practice Address - Phone:401-235-7000
Practice Address - Fax:401-767-4516
Is Sole Proprietor?:No
Enumeration Date:2007-10-30
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker