Provider Demographics
NPI:1790221521
Name:SCANGAS, ANASTASIA (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:ANASTASIA
Middle Name:
Last Name:SCANGAS
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 N MICHIGAN AVE STE 826
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-3793
Mailing Address - Country:US
Mailing Address - Phone:773-371-2956
Mailing Address - Fax:312-489-8492
Practice Address - Street 1:30 N MICHIGAN AVE STE 826
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602
Practice Address - Country:US
Practice Address - Phone:773-818-6800
Practice Address - Fax:312-489-8492
Is Sole Proprietor?:No
Enumeration Date:2017-01-18
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490213951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL149021395OtherILLINOIS DEPARTMENT OF FINANCE AND PROFESSIONAL REGULATION