Provider Demographics
NPI:1649647926
Name:EVERETT, ANA (BS-SOC, MPA, PHD)
Entity type:Individual
Prefix:DR
First Name:ANA
Middle Name:
Last Name:EVERETT
Suffix:
Gender:F
Credentials:BS-SOC, MPA, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 AUBURN AVE NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303-2605
Mailing Address - Country:US
Mailing Address - Phone:888-562-4441
Mailing Address - Fax:888-562-4441
Practice Address - Street 1:2956 S RAINBOW DR
Practice Address - Street 2:SUITE 103
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30034-1629
Practice Address - Country:US
Practice Address - Phone:888-562-4441
Practice Address - Fax:888-562-4441
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-21
Last Update Date:2015-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No104100000XBehavioral Health & Social Service ProvidersSocial Worker