Provider Demographics
NPI:1598832529
Name:FIEDLER, ANNETTE (LMHC)
Entity Type:Individual
Prefix:MS
First Name:ANNETTE
Middle Name:
Last Name:FIEDLER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22119 ELMIRA BLVD
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33952-7018
Mailing Address - Country:US
Mailing Address - Phone:941-255-0616
Mailing Address - Fax:941-295-7973
Practice Address - Street 1:22119 ELMIRA BLVD
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-7018
Practice Address - Country:US
Practice Address - Phone:941-255-0616
Practice Address - Fax:941-295-7973
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH6943101YA0400X, 101YM0800X, 106H00000X, 170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No170300000XOther Service ProvidersGenetic Counselor, MS