MEDICARE: ANNA DOMIRAY 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	34011465A	IN

General Provider Information

NPI Number	:	1154140358
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA DOMIRAY LCSW

Provider Business Mailing Address
First Line	:	1015 E MAIN ST STE 200
Second Line	:
City	:	NEW ALBANY
State	:	IN
Zip	:	47150-5842
Country	:	US
Telephone Number	:	812-605-5201
Fax Number	:

Provider Business Practice Location Address
First Line	:	1015 E MAIN ST STE 200
Second Line	:
City	:	NEW ALBANY
State	:	IN
Zip	:	47150-5842
Country	:	US
Telephone Number	:	812-605-5201
Fax Number	:

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

Provider Enumeration Date	:	10/07/2024
Last Update Date	:	10/24/2025

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Directions to “ ANNA DOMIRAY LCSW” Practice Location

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