Provider Demographics
NPI:1326188475
Name:SMITH, ANNA MARIA (MC, LPC, LISAC)
Entity Type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:MARIA
Last Name:SMITH
Suffix:
Gender:F
Credentials:MC, LPC, LISAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 N DOBSON RD STE 110
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85201-5276
Mailing Address - Country:US
Mailing Address - Phone:480-964-8771
Mailing Address - Fax:480-964-8865
Practice Address - Street 1:430 N DOBSON RD STE 110
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85201-5276
Practice Address - Country:US
Practice Address - Phone:480-964-8771
Practice Address - Fax:480-964-8865
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLISAC-10950101YA0400X
AZLPC-11596101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health