MEDICARE: ANITA LOUISE LENAS 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	SW4402	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Z031D	OTHER	FL	BLUE CROSS/BLUE SHIELD

General Provider Information

NPI Number	:	1942499934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANITA LOUISE LENAS LCSW

Provider Business Mailing Address
First Line	:	2150 49TH ST N
Second Line	:	SUITE D
City	:	ST PETERSBURG
State	:	FL
Zip	:	33710-5237
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2150 49TH ST N
Second Line	:	SUITE D
City	:	ST PETERSBURG
State	:	FL
Zip	:	33710-5237
Country	:	US
Telephone Number	:	727-322-6123
Fax Number	:

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

Provider Enumeration Date	:	10/16/2007
Last Update Date	:	10/16/2007

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