Provider Demographics
NPI:1851486864
Name:RINGO, ANITA LOUISE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ANITA
Middle Name:LOUISE
Last Name:RINGO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 WAYNE DR APT 320
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-4122
Mailing Address - Country:US
Mailing Address - Phone:610-937-7085
Mailing Address - Fax:215-732-8240
Practice Address - Street 1:255 S 17TH ST
Practice Address - Street 2:SUITE 1405
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-6231
Practice Address - Country:US
Practice Address - Phone:215-732-6308
Practice Address - Fax:215-732-8240
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC27731041C0700X
PACW016399101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME104000000Medicaid
MEMM802501Medicare PIN