Provider Demographics
NPI:1457013203
Name:YAS, ANNA E (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:E
Last Name:YAS
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 1:3045 W SUNNYSIDE AVE # 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-3846
Mailing Address - Country:US
Mailing Address - Phone:612-242-6064
Mailing Address - Fax:
Practice Address - Street 1:3166 N LINCOLN AVE STE 400B
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-3174
Practice Address - Country:US
Practice Address - Phone:612-242-6064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-08
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0189041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical