Provider Demographics
NPI:1033723705
Name:MACHIN, ANNA ELAINE (LCSWA)
Entity Type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:ELAINE
Last Name:MACHIN
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:MISS
Other - First Name:ANNA
Other - Middle Name:ELAINE
Other - Last Name:JACOBSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:212 GETTYSBURG DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-5162
Mailing Address - Country:US
Mailing Address - Phone:919-624-6590
Mailing Address - Fax:
Practice Address - Street 1:105 WIND CHIME CT
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-6460
Practice Address - Country:US
Practice Address - Phone:919-916-5006
Practice Address - Fax:919-916-5313
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP014505104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker