Provider Demographics
NPI:1710358874
Name:KASPARK, ANNA (LMSW LCSW-C LICSW)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:KASPARK
Suffix:
Gender:F
Credentials:LMSW LCSW-C LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 CONNECTICUT AVE NW STE 611
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-1764
Mailing Address - Country:US
Mailing Address - Phone:202-630-8120
Mailing Address - Fax:
Practice Address - Street 1:1350 CONNECTICUT AVE NW STE 611
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-1764
Practice Address - Country:US
Practice Address - Phone:202-630-8120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-15
Last Update Date:2020-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500817341041C0700X
MD199591041C0700X
MI68011019211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical