MEDICARE: MS. ANNE KONIGSBERG LCSW, BCD

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	11071	CA

General Provider Information

NPI Number	:	1225156540
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANNE KONIGSBERG LCSW, BCD

Provider Business Mailing Address
First Line	:	5580 E 2ND ST
Second Line	:	SUITE 210
City	:	LONG BEACH
State	:	CA
Zip	:	90803-3946
Country	:	US
Telephone Number	:	562-434-2373
Fax Number	:

Provider Business Practice Location Address
First Line	:	5580 E 2ND ST
Second Line	:	SUITE 210
City	:	LONG BEACH
State	:	CA
Zip	:	90803-3946
Country	:	US
Telephone Number	:	562-434-2373
Fax Number	:

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

Provider Enumeration Date	:	03/26/2007
Last Update Date	:	07/09/2007

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