Provider Demographics
NPI:1104023522
Name:RAFFENAUD-MACKER, ANN ELAINE (LMHC)
Entity type:Individual
Prefix:MS
First Name:ANN
Middle Name:ELAINE
Last Name:RAFFENAUD-MACKER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 S CALUMET RD STE 3B
Mailing Address - Street 2:
Mailing Address - City:CHESTERTON
Mailing Address - State:IN
Mailing Address - Zip Code:46304-3279
Mailing Address - Country:US
Mailing Address - Phone:219-228-7630
Mailing Address - Fax:
Practice Address - Street 1:1100 S CALUMET RD STE 3B
Practice Address - Street 2:
Practice Address - City:CHESTERTON
Practice Address - State:IN
Practice Address - Zip Code:46304-3279
Practice Address - Country:US
Practice Address - Phone:219-228-7630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2025-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39005662A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty