Provider Demographics
NPI:1356827992
Name:BIJMAN, ANNE CHARETTE (LCSW)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:CHARETTE
Last Name:BIJMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:CHARETTE
Other - Last Name:VANASSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW, LCSW
Mailing Address - Street 1:3440 MARKET ST STE 200
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-3336
Mailing Address - Country:US
Mailing Address - Phone:267-250-4790
Mailing Address - Fax:
Practice Address - Street 1:3440 MARKET ST STE 200
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-3336
Practice Address - Country:US
Practice Address - Phone:267-250-4790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-17
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW133652104100000X
PACW0200911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker