Provider Demographics
NPI:1811092174
Name:MAGUN, ANITA (L,C,S,W,)
Entity type:Individual
Prefix:MS
First Name:ANITA
Middle Name:
Last Name:MAGUN
Suffix:
Gender:F
Credentials:L,C,S,W,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 S OCEAN BLVD PH 1
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33487-5390
Mailing Address - Country:US
Mailing Address - Phone:561-447-8604
Mailing Address - Fax:
Practice Address - Street 1:4600 S OCEAN BLVD PH 1
Practice Address - Street 2:
Practice Address - City:HIGHLAND BEACH
Practice Address - State:FL
Practice Address - Zip Code:33487-5390
Practice Address - Country:US
Practice Address - Phone:561-447-8604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 56181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical