Provider Demographics
NPI:1548594427
Name:SALAMONE, ANNA MARIE (LCSW)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:MARIE
Last Name:SALAMONE
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 1:401 E STATE ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-4400
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:401 E STATE ST
Practice Address - Street 2:SUITE 201
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-4400
Practice Address - Country:US
Practice Address - Phone:607-256-3959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-25
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR023694-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical