Provider Demographics
NPI:1427816073
Name:SOSELY, ANNA FLOWER (MA, NCSC, NCC, LPC)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:FLOWER
Last Name:SOSELY
Suffix:
Gender:F
Credentials:MA, NCSC, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 JACOBS RD
Mailing Address - Street 2:
Mailing Address - City:ROCKAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07866-4603
Mailing Address - Country:US
Mailing Address - Phone:973-760-4820
Mailing Address - Fax:
Practice Address - Street 1:221 RIVER ST STE 9
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-5990
Practice Address - Country:US
Practice Address - Phone:646-941-7645
Practice Address - Fax:929-596-7897
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-08
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC01013700101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ873043970OtherHEADWAY, BUSINESS IDENTIFIER