Provider Demographics
NPI:1982942439
Name:SREEDHAR, ANITA H (LCSW)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:H
Last Name:SREEDHAR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 TUXEDO PL
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:NY
Mailing Address - Zip Code:10532-1010
Mailing Address - Country:US
Mailing Address - Phone:914-391-2558
Mailing Address - Fax:
Practice Address - Street 1:4419 3RD AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-2562
Practice Address - Country:US
Practice Address - Phone:718-364-7700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-17
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0749611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical