Healthcare Provider Details

I. General information

NPI: 1528697232
Provider Name (Legal Business Name): SACHI ANANDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2020
Last Update Date: 04/04/2020
Certification Date: 04/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 BRINY AVE APT 2605
POMPANO BEACH FL
33062-5669
US

IV. Provider business mailing address

111 BRINY AVE APT 2605
POMPANO BEACH FL
33062-5669
US

V. Phone/Fax

Practice location:
  • Phone: 954-788-1566
  • Fax:
Mailing address:
  • Phone: 954-788-1566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: DR. SACHI ANANDA
Title or Position: PRESIDENT
Credential: PHD, LMHC, MCAP
Phone: 954-778-1566