Provider Demographics
NPI:1609880129
Name:FINNEGAN, ANNE COOK (LISW, LICDC)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:COOK
Last Name:FINNEGAN
Suffix:
Gender:F
Credentials:LISW, LICDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29525 CHAGRIN BLVD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4644
Mailing Address - Country:US
Mailing Address - Phone:216-224-6375
Mailing Address - Fax:
Practice Address - Street 1:29525 CHAGRIN BLVD
Practice Address - Street 2:SUITE 303
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4644
Practice Address - Country:US
Practice Address - Phone:216-224-6375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH892637101YA0400X
OHI41341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSW05756Medicare ID - Type Unspecified