Provider Demographics
NPI:1518543180
Name:GOLDSMITH, ANNA MARIE (LICSW)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:MARIE
Last Name:GOLDSMITH
Suffix:
Gender:
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1153 16TH AVE SE STE 101
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55414-2495
Mailing Address - Country:US
Mailing Address - Phone:651-390-1558
Mailing Address - Fax:
Practice Address - Street 1:1153 16TH AVE SE STE 114
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55414-2495
Practice Address - Country:US
Practice Address - Phone:651-747-6481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-23
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN253141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical