Provider Demographics
NPI:1326702366
Name:EKPO, ANASTASIYA (LCSW)
Entity type:Individual
Prefix:
First Name:ANASTASIYA
Middle Name:
Last Name:EKPO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ANASTASIYA
Other - Middle Name:
Other - Last Name:SAMSANOVICH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 8506
Mailing Address - Street 2:
Mailing Address - City:RED BLUFF
Mailing Address - State:CA
Mailing Address - Zip Code:96080-8506
Mailing Address - Country:US
Mailing Address - Phone:530-528-2342
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 8506
Practice Address - Street 2:
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080-8506
Practice Address - Country:US
Practice Address - Phone:530-528-2342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-26
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1226401041C0700X, 101YM0800X
CAASW103312101YM0800X
CA103312101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical