Provider Demographics
NPI:1295740157
Name:ANANIS, ROSEMARY (MSW)
Entity type:Individual
Prefix:MS
First Name:ROSEMARY
Middle Name:
Last Name:ANANIS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1375
Mailing Address - Street 2:
Mailing Address - City:WELLS
Mailing Address - State:ME
Mailing Address - Zip Code:04090-1375
Mailing Address - Country:US
Mailing Address - Phone:207-646-6641
Mailing Address - Fax:207-646-6953
Practice Address - Street 1:43 SANFORD RD.
Practice Address - Street 2:
Practice Address - City:WELLS
Practice Address - State:ME
Practice Address - Zip Code:04090
Practice Address - Country:US
Practice Address - Phone:207-646-6641
Practice Address - Fax:207-646-6953
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC30191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME003087OtherHPHC
ME005587OtherANTHEM BCBS
ME1036618OtherCIGNA
MEA003299OtherVALUE OPTIONS
ME100723OtherMAGELLAN
MEE004524OtherCHAMPVA
MEMM4009Medicare ID - Type Unspecified