Provider Demographics
NPI:1093055626
Name:HANEY, ANNE M (LPC)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:M
Last Name:HANEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:M
Other - Last Name:MALLORY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:227 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PAYETTE
Mailing Address - State:ID
Mailing Address - Zip Code:83661-2852
Mailing Address - Country:US
Mailing Address - Phone:208-809-9263
Mailing Address - Fax:
Practice Address - Street 1:227 S MAIN ST
Practice Address - Street 2:
Practice Address - City:PAYETTE
Practice Address - State:ID
Practice Address - Zip Code:83661-2852
Practice Address - Country:US
Practice Address - Phone:208-230-2989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-19
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID10118101YA0400X
IDLPC 5177101YP2500X
IDLPC-5177101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional