Basic Information
| Provider Information | |||||||||
| NPI: | 1750704318 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CONN | ||||||||
| FirstName: | ANNA | ||||||||
| MiddleName: | SHUMOLIS | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | LCSWA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1316 PATTON AVE STE D | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288062652 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282253100 | ||||||||
| FaxNumber: | 8282253604 | ||||||||
| Practice Location | |||||||||
| Address1: | 1355 CHARLOTTE HWY | ||||||||
| Address2: | |||||||||
| City: | FAIRVIEW | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287308798 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286282732 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/31/2014 | ||||||||
| LastUpdateDate: | 01/31/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | P008007 | NC | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.