Provider Demographics
NPI:1891107249
Name:VANDERBIEST, ANNA (LCSW, CMC)
Entity Type:Individual
Prefix:MS
First Name:ANNA
Middle Name:
Last Name:VANDERBIEST
Suffix:
Gender:F
Credentials:LCSW, CMC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6141 SW 128TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-5471
Mailing Address - Country:US
Mailing Address - Phone:305-389-1840
Mailing Address - Fax:
Practice Address - Street 1:8400 NW 33RD ST
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33122-1937
Practice Address - Country:US
Practice Address - Phone:786-405-3948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-20
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW118511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical