Provider Demographics
NPI:1457683252
Name:MESICH, ANNE OLIVIA (LPC, CRC, MS)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:OLIVIA
Last Name:MESICH
Suffix:
Gender:F
Credentials:LPC, CRC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2026 JENIFER ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-5527
Mailing Address - Country:US
Mailing Address - Phone:608-283-6315
Mailing Address - Fax:
Practice Address - Street 1:2002 ATWOOD AVE STE 203
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-5384
Practice Address - Country:US
Practice Address - Phone:608-556-0752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-03
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4134125101YP2500X
WI1254134101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional