Provider Demographics
NPI:1720212301
Name:CACCHIONE, ANNA I (LISW-S)
Entity Type:Individual
Prefix:MS
First Name:ANNA
Middle Name:I
Last Name:CACCHIONE
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3769 FREEDOM PL
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-4427
Mailing Address - Country:US
Mailing Address - Phone:440-308-5674
Mailing Address - Fax:
Practice Address - Street 1:3769 FREEDOM PL
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44053-4427
Practice Address - Country:US
Practice Address - Phone:440-308-5674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-11
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1041C0700X1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical