Provider Demographics
NPI:1851713010
Name:WITTENBERG, ANNE COLBY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:COLBY
Last Name:WITTENBERG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:COLBY
Other - Last Name:STACKHOUSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1314 DOGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22302-2721
Mailing Address - Country:US
Mailing Address - Phone:703-244-5906
Mailing Address - Fax:
Practice Address - Street 1:1314 DOGWOOD DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22302-2721
Practice Address - Country:US
Practice Address - Phone:703-244-5906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-07
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040081481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical