Provider Demographics
NPI:1851835805
Name:AXELROD, ANNA
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:AXELROD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:LIVCHITS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:441 TOMLINSON RD APT F20
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19116-3249
Mailing Address - Country:US
Mailing Address - Phone:773-988-9460
Mailing Address - Fax:
Practice Address - Street 1:441 TOMLINSON RD APT F20
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19116-3249
Practice Address - Country:US
Practice Address - Phone:773-988-9460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-09
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical