Provider Demographics
NPI:1114481264
Name:ANCHOR THERAPY, PLLC
Entity Type:Organization
Organization Name:ANCHOR THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL THERAPIST/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:KATE
Authorized Official - Last Name:FERRIS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:847-894-1797
Mailing Address - Street 1:8386 S UPHAM WAY
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80128-6324
Mailing Address - Country:US
Mailing Address - Phone:847-894-1797
Mailing Address - Fax:
Practice Address - Street 1:90 MADISON ST STE 504
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-5414
Practice Address - Country:US
Practice Address - Phone:847-894-1797
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-23
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000148220Medicaid