Provider Demographics
NPI:1437977311
Name:MYERS, ANNA GRACE (LCSW)
Entity type:Individual
Prefix:MISS
First Name:ANNA
Middle Name:GRACE
Last Name:MYERS
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 1:206 W SPRINGFIELD ST APT 3
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-3468
Mailing Address - Country:US
Mailing Address - Phone:203-583-0524
Mailing Address - Fax:
Practice Address - Street 1:185 DEVONSHIRE ST STE 800
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02110-1414
Practice Address - Country:US
Practice Address - Phone:617-552-5116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALCSW2308921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical