Provider Demographics
NPI:1548414899
Name:MACEIRA, ANNA CHRISTINE (CADC II)
Entity Type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:CHRISTINE
Last Name:MACEIRA
Suffix:
Gender:F
Credentials:CADC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1529 WILTSEY RD SE APT 220
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97306-8558
Mailing Address - Country:US
Mailing Address - Phone:503-399-0670
Mailing Address - Fax:
Practice Address - Street 1:3878 BEVERLY AVE NE STE 5
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97305-1335
Practice Address - Country:US
Practice Address - Phone:503-399-0670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-13
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10-06-57101YA0400X
OR08-08-21101YA0400X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR10-06-57OtherCERTIFIED ALCOHOL AND DRUG COUNSELOR
OR10-06-57Medicaid
OR08-08-21OtherADDICTION COUNSELOR CERTIFICATION BOARD OF OREGON