Provider Demographics
NPI:1013291194
Name:WEERASINGHE, ANNE (LICSW)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:WEERASINGHE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:
Other - Last Name:SHIBILSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:6804 IROQUOIS CIR
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55439-1014
Mailing Address - Country:US
Mailing Address - Phone:126-564-9772
Mailing Address - Fax:612-225-1854
Practice Address - Street 1:6804 IROQUOIS CIR
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55439-1014
Practice Address - Country:US
Practice Address - Phone:612-564-9772
Practice Address - Fax:612-225-1854
Is Sole Proprietor?:No
Enumeration Date:2011-10-06
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN197771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical