Provider Demographics
NPI:1710044946
Name:MARCEL DE HERMANAS, ANNA (LSW, LPCC)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:MARCEL DE HERMANAS
Suffix:
Gender:F
Credentials:LSW, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 643
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-0643
Mailing Address - Country:US
Mailing Address - Phone:740-374-5853
Mailing Address - Fax:740-374-6332
Practice Address - Street 1:200 UNION SQ STE 1
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-3033
Practice Address - Country:US
Practice Address - Phone:740-373-3001
Practice Address - Fax:740-373-3042
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2008-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE2377101YM0800X
WV1812101YM0800X
OHS9206104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH11589524OtherCAQH
OHS9206OtherSOCIAL WORK LICENSE
OHE2377OtherCLINICAL COUNSELOR LICENS
OH138617OtherVALUEOPTIONS PROVIDER