Provider Demographics
NPI:1831531458
Name:ANAND, MA LAXMI (MCAP-100609)
Entity type:Individual
Prefix:
First Name:MA LAXMI
Middle Name:
Last Name:ANAND
Suffix:
Gender:F
Credentials:MCAP-100609
Other - Prefix:
Other - First Name:LYDIA
Other - Middle Name:
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCAS
Mailing Address - Street 1:151 N BEACH RD
Mailing Address - Street 2:
Mailing Address - City:DANIA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33004-3023
Mailing Address - Country:US
Mailing Address - Phone:305-807-4786
Mailing Address - Fax:
Practice Address - Street 1:151 N BEACH RD # D9
Practice Address - Street 2:
Practice Address - City:DANIA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33004-3023
Practice Address - Country:US
Practice Address - Phone:305-807-4786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-24
Last Update Date:2019-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMCAP100609101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL100609OtherMASTER CERTIFIED ADDICTION PROFESSIONAL MCAP