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NPI Code Detail

MEDICARE: ANNALESE RAYEN DUTCH LCSW

MEDICARE: ANNALESE RAYEN DUTCH 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
11041C0700XClinical Social WorkerC004007NC

General Provider Information

NPI Number : 1295414233
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNALESE RAYEN DUTCH LCSW
Provider Business Mailing Address
First Line : 100 MCCHESNEY AVE BLDG I-03
Second Line :
City : TROY
State : NY
Zip : 12180-8800
Country : US
Telephone Number : 315-528-9126
Fax Number :
Provider Business Practice Location Address
First Line : 225 N MICHIGAN AVE STE 1430
Second Line :
City : CHICAGO
State : IL
Zip : 60601-7653
Country : US
Telephone Number : 312-766-6780
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2023
Last Update Date : 05/05/2026

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Directions to “ ANNALESE RAYEN DUTCH LCSW” Practice Location

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