Provider Demographics
NPI:1316582125
Name:HERNANDEZ GRANGER, ANNA KALEN (LMHC)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:KALEN
Last Name:HERNANDEZ GRANGER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:KALEN
Other - Last Name:GRANGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1185 W CARMEL DR STE D4
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-8708
Mailing Address - Country:US
Mailing Address - Phone:317-569-5433
Mailing Address - Fax:
Practice Address - Street 1:1185 W CARMEL DR STE D4
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-8708
Practice Address - Country:US
Practice Address - Phone:317-569-5433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-15
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39003674A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health