Provider Demographics
NPI:1548260979
Name:CITRON, ANJELINA (MSW, CSW, LICSW)
Entity type:Individual
Prefix:MS
First Name:ANJELINA
Middle Name:
Last Name:CITRON
Suffix:
Gender:F
Credentials:MSW, CSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 982
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98227-0982
Mailing Address - Country:US
Mailing Address - Phone:360-676-2443
Mailing Address - Fax:360-715-3453
Practice Address - Street 1:203 W HOLLY ST
Practice Address - Street 2:SUITE 326
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4364
Practice Address - Country:US
Practice Address - Phone:360-676-2443
Practice Address - Fax:360-715-3453
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000041761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB10865Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER