Healthcare Provider Details

I. General information

NPI: 1093987380
Provider Name (Legal Business Name): ANNE PARKS YACKEE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2008
Last Update Date: 09/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 JOHN ST 27 FLOOR
NEW YORK NY
10038-3300
US

IV. Provider business mailing address

116 JOHN ST 27 FLOOR
NEW YORK NY
10038-3300
US

V. Phone/Fax

Practice location:
  • Phone: 212-385-0086
  • Fax: 212-732-0757
Mailing address:
  • Phone: 212-385-0086
  • Fax: 212-732-0757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: