Anne Antonenko, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CWO15279 Issued in PA

Practice address

1575 N 52ND St Ste 800
Philadelphia, PA 19131-4741

Phone

(215) 694-6282

NPI assigned

Mar 1, 2018

Last updated

Mar 1, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mercy Management of Sepa

  dba MMSEPA P PCP 52nd Office

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1932623857

  Clinical

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1519862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519862400000",
    "number": "1790287274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1575 N 52ND ST STE 800",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191314741",
            "telephone_number": "215-694-6282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 N 52ND ST STE 800",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191314741",
            "telephone_number": "215-694-6282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONENKO",
        "first_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-01",
        "last_updated": "2018-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CWO15279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Antolos, RD
• Maria del Pilar Anton Martin, MD, PHD
• Kevin Anton, M.D., PH.D.
• Nicolette Gabrielle Anton
• Caroline Antonacci, MD
• Antonia Pantoja Charter School
• Antonia Pantoja Community Charter School
• Maria Antoniou, MD
• Anna Antonova
• Joshua Antos

• Clinical Social Worker in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.