Provider Demographics
NPI:1457837197
Name:ANDERSON LENKIEWICZ, LENA
Entity Type:Individual
Prefix:MRS
First Name:LENA
Middle Name:
Last Name:ANDERSON LENKIEWICZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4647 PENDALL DR
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-1154
Mailing Address - Country:US
Mailing Address - Phone:907-723-7591
Mailing Address - Fax:
Practice Address - Street 1:4647 PENDALL DR
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-1154
Practice Address - Country:US
Practice Address - Phone:907-723-7591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-16
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC106S00000X
VA106S00000X
MD106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician