Provider Demographics
NPI:1639545650
Name:GOLDFRIED, ANITA POWERS (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ANITA
Middle Name:POWERS
Last Name:GOLDFRIED
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:ANITA
Other - Middle Name:P
Other - Last Name:GOLDFRIED
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:1430 SECOND AVE.
Mailing Address - Street 2:SUITE 109
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021
Mailing Address - Country:US
Mailing Address - Phone:917-974-8964
Mailing Address - Fax:
Practice Address - Street 1:1430 SECOND AVE.
Practice Address - Street 2:SUITE 109
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021
Practice Address - Country:US
Practice Address - Phone:917-974-8964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-13
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPRO24528-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical