Provider Demographics
| NPI: | 1487664736 |
|---|---|
| Name: | WELLMAN, ANNA M (JD MSW LCSW) |
| Entity type: | Individual |
| Prefix: | |
| First Name: | ANNA |
| Middle Name: | M |
| Last Name: | WELLMAN |
| Suffix: | |
| Gender: | F |
| Credentials: | JD MSW LCSW |
| Other - Prefix: | |
| Other - First Name: | |
| Other - Middle Name: | |
| Other - Last Name: | |
| Other - Suffix: | |
| Other - Last Name Type: | |
| Other - Credentials: | |
| Mailing Address - Street 1: | 910 JEFFERSON AVENUE |
| Mailing Address - Street 2: | |
| Mailing Address - City: | NEW ORLEANS |
| Mailing Address - State: | LA |
| Mailing Address - Zip Code: | 70115 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 504-654-9093 |
| Mailing Address - Fax: | 504-617-6343 |
| Practice Address - Street 1: | 910 JEFFERSON AVENUE |
| Practice Address - Street 2: | |
| Practice Address - City: | NEW ORLEANS |
| Practice Address - State: | LA |
| Practice Address - Zip Code: | 70115 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 504-654-9093 |
| Practice Address - Fax: | 504-617-6343 |
| Is Sole Proprietor?: | Yes |
| Enumeration Date: | 2006-08-09 |
| Last Update Date: | 2025-09-11 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| LA | 3689 | 104100000X, 1041C0700X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical |
| No | 104100000X | Behavioral Health & Social Service Providers | Social Worker |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| LA | 1671096 | Medicaid | |
| LA | 1671096 | Medicaid | |
| LA | 5T848 | Medicare ID - Type Unspecified |