Provider Demographics
NPI:1629564166
Name:ORDOUBADI, ANNA LEE DILLON (LCSW)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:LEE DILLON
Last Name:ORDOUBADI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:LEE
Other - Last Name:DILLON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:221 MINT HILL DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-6104
Mailing Address - Country:US
Mailing Address - Phone:919-244-4863
Mailing Address - Fax:
Practice Address - Street 1:5000 FALLS OF NEUSE RD STE 300
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-5480
Practice Address - Country:US
Practice Address - Phone:919-865-8710
Practice Address - Fax:919-256-0772
Is Sole Proprietor?:No
Enumeration Date:2018-07-09
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0111031041C0700X
NCC0145721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical