Provider Demographics
NPI:1386694537
Name:ABRUSCATO, ANNE MARIE (LCSW)
Entity type:Individual
Prefix:MS
First Name:ANNE
Middle Name:MARIE
Last Name:ABRUSCATO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3618 KARAOKE CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-5055
Mailing Address - Country:US
Mailing Address - Phone:702-501-7816
Mailing Address - Fax:702-253-9625
Practice Address - Street 1:6375 W CHARLESTON BLVD
Practice Address - Street 2:A100
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-1139
Practice Address - Country:US
Practice Address - Phone:702-253-0818
Practice Address - Fax:702-253-9625
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4295-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
V100166Medicare ID - Type UnspecifiedMEDICARE
NVQ34691Medicare UPIN