Provider Demographics
NPI:1831774413
Name:BOESMANS, ANOUCHKA (LMSW)
Entity type:Individual
Prefix:
First Name:ANOUCHKA
Middle Name:
Last Name:BOESMANS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:699 104TH AVE N
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34108-3228
Mailing Address - Country:US
Mailing Address - Phone:646-706-6027
Mailing Address - Fax:
Practice Address - Street 1:65 RIVINGTON ST APT 5
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-2107
Practice Address - Country:US
Practice Address - Phone:646-706-6027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-15
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY110848104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker