Provider Demographics
NPI:1255565800
Name:MINICH, ANNE LESLEY (LCSW)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:LESLEY
Last Name:MINICH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 E. 68TH STREET
Mailing Address - Street 2:NEW YORK PRESBYTERIAN HOSPITAL
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021
Mailing Address - Country:US
Mailing Address - Phone:212-746-5464
Mailing Address - Fax:212-746-8165
Practice Address - Street 1:525 E. 68TH STREET
Practice Address - Street 2:NEW YORK PRESBYTERIAN HOSPITAL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021
Practice Address - Country:US
Practice Address - Phone:212-746-5464
Practice Address - Fax:212-746-8165
Is Sole Proprietor?:No
Enumeration Date:2009-05-12
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0713171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical