Provider Demographics
NPI:1891068136
Name:MONTEFIORE, ANYA (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:ANYA
Middle Name:
Last Name:MONTEFIORE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MS
Other - First Name:BEATRIZ
Other - Middle Name:
Other - Last Name:JORDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:412 WALDEN LN
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-8408
Mailing Address - Country:US
Mailing Address - Phone:305-297-3705
Mailing Address - Fax:
Practice Address - Street 1:1734 HIRAM ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32209-6105
Practice Address - Country:US
Practice Address - Phone:305-297-3705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-16
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH2866101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health