Provider Demographics
NPI:1578237772
Name:BIANCO, ANNA MARIA (LMSW)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:MARIA
Last Name:BIANCO
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 1:43 WALL ST APT 2
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-2436
Mailing Address - Country:US
Mailing Address - Phone:315-406-7522
Mailing Address - Fax:
Practice Address - Street 1:101 HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-5028
Practice Address - Country:US
Practice Address - Phone:315-253-5385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY111945104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker