Provider Demographics
NPI:1902605603
Name:FRENTSOS, ANNIE LARUE (LMSW)
Entity type:Individual
Prefix:
First Name:ANNIE
Middle Name:LARUE
Last Name:FRENTSOS
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 HAMPDEN LN APT T01
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-7908
Mailing Address - Country:US
Mailing Address - Phone:240-328-8170
Mailing Address - Fax:
Practice Address - Street 1:5480 WISCONSIN AVE STE 203
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-3524
Practice Address - Country:US
Practice Address - Phone:240-780-8665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD32193104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker