Provider Demographics
NPI:1184942195
Name:RONIS, ANITA PERRONE (LCSW,CASAC)
Entity type:Individual
Prefix:MRS
First Name:ANITA
Middle Name:PERRONE
Last Name:RONIS
Suffix:
Gender:F
Credentials:LCSW,CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 E 73RD ST
Mailing Address - Street 2:SUITE 5A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-3567
Mailing Address - Country:US
Mailing Address - Phone:212-920-1978
Mailing Address - Fax:
Practice Address - Street 1:51 E 73RD ST
Practice Address - Street 2:SUITE 5A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-3567
Practice Address - Country:US
Practice Address - Phone:212-920-1978
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-14
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY18591101YA0400X
NY077471101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYTAX ID 46-0666841OtherNY LICENSE # 077471