Provider Demographics
NPI:1982618864
Name:PEURASAARI, ANNE (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:
Last Name:PEURASAARI
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5018 DORSEY HALL DRIVE
Mailing Address - Street 2:#205
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042
Mailing Address - Country:US
Mailing Address - Phone:410-992-4940
Mailing Address - Fax:410-730-1513
Practice Address - Street 1:5018 DORSEY HALL DRIVE
Practice Address - Street 2:#205
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042
Practice Address - Country:US
Practice Address - Phone:410-992-4940
Practice Address - Fax:410-730-1513
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD075511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD126500800Medicaid
MDR1960001OtherFED BC