Healthcare Provider Details

I. General information

NPI: 1013356484
Provider Name (Legal Business Name): ANNA MANDIA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2013
Last Update Date: 02/17/2026
Certification Date: 02/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 SKYLINE DR UNIT 15
FISHKILL NY
12524-3639
US

IV. Provider business mailing address

11 SKYLINE DR UNIT 15
FISHKILL NY
12524-3639
US

V. Phone/Fax

Practice location:
  • Phone: 845-264-4110
  • Fax:
Mailing address:
  • Phone: 845-264-4110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW20556
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number094983
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: