Provider Demographics
NPI:1306181573
Name:WILLE, ANNE K (MS LPC)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:K
Last Name:WILLE
Suffix:
Gender:F
Credentials:MS LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 WHITE BARN PKWY
Mailing Address - Street 2:
Mailing Address - City:OSTRANDER
Mailing Address - State:OH
Mailing Address - Zip Code:43061-9010
Mailing Address - Country:US
Mailing Address - Phone:219-928-3613
Mailing Address - Fax:
Practice Address - Street 1:180 WHITE BARN PKWY
Practice Address - Street 2:
Practice Address - City:OSTRANDER
Practice Address - State:OH
Practice Address - Zip Code:43061-9010
Practice Address - Country:US
Practice Address - Phone:219-928-3613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-29
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYPPC-669101Y00000X
OHC.2103854101YM0800X
WYLPC - 1449101YP2500X
WYLPC-1449101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY134420000OtherWY STATE PROVIDER #
WYLPC - 1449OtherSTATE LICENSE
WYPPC-669OtherSTATE