Provider Demographics
NPI:1508586611
Name:ANDERSON, ANNELLE (LMSW-T)
Entity Type:Individual
Prefix:
First Name:ANNELLE
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:LMSW-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5401 SW 7TH ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-2330
Mailing Address - Country:US
Mailing Address - Phone:785-273-2252
Mailing Address - Fax:785-273-7489
Practice Address - Street 1:400 SW OAKLEY AVE
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-2039
Practice Address - Country:US
Practice Address - Phone:785-233-1730
Practice Address - Fax:785-354-1068
Is Sole Proprietor?:No
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS12753-T104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker