MEDICARE: ANA RICHARD LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	SW24418	FL

General Provider Information

NPI Number	:	1003359621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANA RICHARD LCSW

Provider Business Mailing Address
First Line	:	179 ELLERY LN
Second Line	:
City	:	PANAMA CITY BEACH
State	:	FL
Zip	:	32413-2280
Country	:	US
Telephone Number	:	504-273-9843
Fax Number	:

Provider Business Practice Location Address
First Line	:	179 ELLERY LN
Second Line	:
City	:	PANAMA CITY BEACH
State	:	FL
Zip	:	32413-2280
Country	:	US
Telephone Number	:	504-273-9843
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2016
Last Update Date	:	01/05/2026

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