Provider Demographics
NPI:1114676061
Name:ANNA'S ALCOVE
Entity Type:Organization
Organization Name:ANNA'S ALCOVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:DWYER
Authorized Official - Last Name:SKINNER
Authorized Official - Suffix:
Authorized Official - Credentials:MED, NCC, LPC, CAADC
Authorized Official - Phone:267-458-2927
Mailing Address - Street 1:20 VINE ST UNIT 1102
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-8757
Mailing Address - Country:US
Mailing Address - Phone:267-458-2927
Mailing Address - Fax:267-291-6468
Practice Address - Street 1:732 W 3RD ST
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-2111
Practice Address - Country:US
Practice Address - Phone:267-458-2927
Practice Address - Fax:267-291-6468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-19
Last Update Date:2022-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty