Provider Demographics
NPI:1154146975
Name:GIPS, ANYA (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:ANYA
Middle Name:
Last Name:GIPS
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1422 COMMONWEALTH AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-3717
Mailing Address - Country:US
Mailing Address - Phone:551-206-5048
Mailing Address - Fax:
Practice Address - Street 1:313 WASHINGTON ST STE 402
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02458-1626
Practice Address - Country:US
Practice Address - Phone:481-844-8623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2311731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical