MEDICARE: SACHI ANANDA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1528697232
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SACHI ANANDA LLC

Provider Business Mailing Address
First Line	:	111 BRINY AVE APT 2605
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33062-5669
Country	:	US
Telephone Number	:	954-788-1566
Fax Number	:

Provider Business Practice Location Address
First Line	:	111 BRINY AVE APT 2605
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33062-5669
Country	:	US
Telephone Number	:	954-788-1566
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SACHI ANANDA
Credential	:	PHD, LMHC, MCAP
Telephone Number	:	954-778-1566

Provider Enumeration Date	:	04/04/2020
Last Update Date	:	04/04/2020

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