Healthcare Provider Details

I. General information

NPI: 1437144805
Provider Name (Legal Business Name): ANITA LOUISE LENAS LCSW INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2005
Last Update Date: 12/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5348 1ST AVE N
ST PETERSBURG FL
33710-8106
US

IV. Provider business mailing address

PO BOX 47918
ST PETERSBURG FL
33743-7918
US

V. Phone/Fax

Practice location:
  • Phone: 727-322-6123
  • Fax: 727-322-6143
Mailing address:
  • Phone: 727-322-6123
  • Fax: 727-322-6143

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW4402
License Number StateFL

VIII. Authorized Official

Name: ANITA LOUISE LENAS
Title or Position: OWNER PRESIDENT
Credential: LCSW
Phone: 727-322-6123