MEDICARE: MS. ANITA M MENDES LICSW

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	464	NH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1040086	OTHER	NH	HCVM
2	412056751	OTHER	NH	HARVARD PILG/PACIFICARE
3	220649741	OTHER	NH	UNITED BEHAVIORAL HEALTH
4	458185	OTHER	NH	TUFTS HEALTH CARE
5	9R0183	OTHER	NH	EMPIRE BCBS
6	1405573Y0NH02	OTHER	NH	BLUE CROSS BLUE SHIELD
7	412056751	OTHER	NH	GREAT WEST
8	463366	OTHER	NH	VALUE OPTIONS
9	477489000	OTHER	NH	MEGELLAN
10	412056751-002	OTHER	NH	AETNA
11	03422476	OTHER	NH	TRI-CARE
12	1040886	OTHER	NH	CIGNA BEHAV. HEALTH CARE
13	213591	OTHER	NH	COMPPSYCH
14	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
15	412056751	OTHER	NH	UNITED BEHAVIORAL HEALTH
16	550010007027	OTHER	NH	PACIFICARE

General Provider Information

NPI Number	:	1912985458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANITA M MENDES LICSW

Provider Business Mailing Address
First Line	:	PO BOX 212
Second Line	:
City	:	HANCOCK
State	:	NH
Zip	:	03449-0212
Country	:	US
Telephone Number	:	603-525-3454
Fax Number	:	603-525-3454

Provider Business Practice Location Address
First Line	:	174 CONCORD STREET
Second Line	:	160
City	:	PETERBOROUGH
State	:	NH
Zip	:	03458-1222
Country	:	US
Telephone Number	:	603-525-3454
Fax Number	:	603-525-3454

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

Provider Enumeration Date	:	01/05/2006
Last Update Date	:	05/26/2009

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