Provider Demographics
NPI:1508346743
Name:ANEZ MORONTA, MARIA TERESA (LMSW)
Entity Type:Individual
Prefix:
First Name:MARIA TERESA
Middle Name:
Last Name:ANEZ MORONTA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1006 ASPEN GLEN DR
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-5313
Mailing Address - Country:US
Mailing Address - Phone:904-469-9834
Mailing Address - Fax:
Practice Address - Street 1:225 W 34TH ST FL 9
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10122-0901
Practice Address - Country:US
Practice Address - Phone:904-469-9834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-16
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY104242-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker