Provider Demographics
NPI:1912442203
Name:DBA SUSAN ANKER,LCSW,MSW
Entity Type:Organization
Organization Name:DBA SUSAN ANKER,LCSW,MSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ANKER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:305-668-9090
Mailing Address - Street 1:11440 N KENDALL DR
Mailing Address - Street 2:SUITE 106
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1044
Mailing Address - Country:US
Mailing Address - Phone:305-668-9090
Mailing Address - Fax:954-447-3894
Practice Address - Street 1:11440 N KENDALL DR
Practice Address - Street 2:SUITE 106
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1044
Practice Address - Country:US
Practice Address - Phone:305-668-9090
Practice Address - Fax:954-447-3894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-22
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW00018431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty