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General NPI Number Information
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NPI Number | 1447572508
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Entity Type | Individual
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Provider Name | ANITA LYN ACEVEDO LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/17/2010
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Last Update Date | 12/21/2025
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Provider Practice Location Address
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Address Line | 301 MONTECITO AVE
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City | CORTE MADERA
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State | CA
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Zip | 94925-1404
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Country | US
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Telephone | 415-686-4379
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Fax |
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Provider Business Mailing Address
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Address Line | 301 MONTECITO AVE
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City | CORTE MADERA
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State | CA
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Zip | 94925-1404
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Country | US
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Telephone | 850-883-8600
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 124828
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 13385
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 120308
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 007203
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License Number State | GA
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 992150
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License Number State | CO
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