Provider Demographics
NPI:1487997003
Name:ANNA SAKHAROVA, LCSW PC
Entity type:Organization
Organization Name:ANNA SAKHAROVA, LCSW PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAKHAROVA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-R
Authorized Official - Phone:718-459-1225
Mailing Address - Street 1:5955 47TH AVE
Mailing Address - Street 2:APT 6B
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-5668
Mailing Address - Country:US
Mailing Address - Phone:718-359-1225
Mailing Address - Fax:718-459-5805
Practice Address - Street 1:9520 63RD RD
Practice Address - Street 2:SUITE J
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-1160
Practice Address - Country:US
Practice Address - Phone:718-459-1225
Practice Address - Fax:718-459-5805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-02
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0511231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty