Provider Demographics
NPI:1629358668
Name:TRUSH, ANITA TAMSIN (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:ANITA
Middle Name:TAMSIN
Last Name:TRUSH
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MRS
Other - First Name:FRANKIE
Other - Middle Name:
Other - Last Name:TRUSH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:130 W 97TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-6450
Mailing Address - Country:US
Mailing Address - Phone:212-665-1860
Mailing Address - Fax:
Practice Address - Street 1:130 W 97TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-6450
Practice Address - Country:US
Practice Address - Phone:212-665-1860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-23
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY083921-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical