Provider Demographics
NPI:1902492275
Name:MAVRIKAKIS, ANNA CHRISTINA (LCSW)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:CHRISTINA
Last Name:MAVRIKAKIS
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2131 41ST ST APT 1A
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11105-1757
Mailing Address - Country:US
Mailing Address - Phone:516-382-8262
Mailing Address - Fax:
Practice Address - Street 1:2131 41ST ST APT 1A
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11105-1757
Practice Address - Country:US
Practice Address - Phone:516-382-8262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-21
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0979901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical