Provider Demographics
NPI:1134781149
Name:GUNADASA, ANNY JENNIFER (MS, LMHC, CAS, CCTP,)
Entity type:Individual
Prefix:MRS
First Name:ANNY
Middle Name:JENNIFER
Last Name:GUNADASA
Suffix:
Gender:
Credentials:MS, LMHC, CAS, CCTP,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10502 SPRING HILL DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34608-5046
Mailing Address - Country:US
Mailing Address - Phone:727-290-5932
Mailing Address - Fax:352-515-0163
Practice Address - Street 1:10502 SPRING HILL DR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34608-5046
Practice Address - Country:US
Practice Address - Phone:352-442-2657
Practice Address - Fax:727-807-3311
Is Sole Proprietor?:No
Enumeration Date:2019-07-01
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20368101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health