Provider Demographics
NPI:1265451454
Name:CREEKMORE, ANNE FILOSA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:FILOSA
Last Name:CREEKMORE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 70442
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23255-0442
Mailing Address - Country:US
Mailing Address - Phone:804-741-2608
Mailing Address - Fax:804-741-1002
Practice Address - Street 1:10315 COLLINWOOD DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23238-4811
Practice Address - Country:US
Practice Address - Phone:804-741-2608
Practice Address - Fax:804-741-1002
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810001196103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA051665OtherANTHEM BLUE CROSS
VA7753128Medicaid