Provider Demographics
NPI:1447341557
Name:ANNASTAS, DENNIS JAMES (LCSWR)
Entity type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:JAMES
Last Name:ANNASTAS
Suffix:
Gender:M
Credentials:LCSWR
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 725
Mailing Address - Street 2:ACCESS INC
Mailing Address - City:NEW PALTZ
Mailing Address - State:NY
Mailing Address - Zip Code:12561
Mailing Address - Country:US
Mailing Address - Phone:845-255-3474
Mailing Address - Fax:845-255-0104
Practice Address - Street 1:113 N CHESTNUT ST
Practice Address - Street 2:ACCESS INC
Practice Address - City:NEW PALTZ
Practice Address - State:NY
Practice Address - Zip Code:12561
Practice Address - Country:US
Practice Address - Phone:845-255-3474
Practice Address - Fax:845-255-0104
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYR0461781104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAQH#11240316OtherWORLDWIDE