Provider Demographics
NPI:1689339954
Name:KISMARIC, ANNA (LCSW)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:KISMARIC
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 CLERMONT AVE APT 3D
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11205-3319
Mailing Address - Country:US
Mailing Address - Phone:917-974-0557
Mailing Address - Fax:
Practice Address - Street 1:68 JAY ST STE 409
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-8361
Practice Address - Country:US
Practice Address - Phone:929-224-2284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-02
Last Update Date:2024-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0974641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical