Provider Demographics
NPI:1003916644
Name:IERARDI, ANNE M (LMHC, DMIN)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:M
Last Name:IERARDI
Suffix:
Gender:F
Credentials:LMHC, DMIN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 ROUTE 6A
Mailing Address - Street 2:
Mailing Address - City:YARMOUTH PORT
Mailing Address - State:MA
Mailing Address - Zip Code:02675-1823
Mailing Address - Country:US
Mailing Address - Phone:508-375-0700
Mailing Address - Fax:508-375-0700
Practice Address - Street 1:408 ROUTE 6A
Practice Address - Street 2:
Practice Address - City:YARMOUTH PORT
Practice Address - State:MA
Practice Address - Zip Code:02675-1823
Practice Address - Country:US
Practice Address - Phone:508-375-0700
Practice Address - Fax:508-375-0700
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA523101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health