Provider Demographics
NPI:1336788538
Name:SOMPOLSKI, ANNA GRACE (LMHC)
Entity Type:Individual
Prefix:MS
First Name:ANNA
Middle Name:GRACE
Last Name:SOMPOLSKI
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 MONTAGUE STREET
Mailing Address - Street 2:CONDO UNIT K, 8TH FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201
Mailing Address - Country:US
Mailing Address - Phone:718-488-0100
Mailing Address - Fax:
Practice Address - Street 1:195 MONTAGUE STREET
Practice Address - Street 2:CONDO UNIT K, 8TH FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201
Practice Address - Country:US
Practice Address - Phone:718-488-0100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-06
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009044101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health