Provider Demographics
NPI:1689010365
Name:RIPPLE, ANNA CHATHAM (LPC, LCASA)
Entity Type:Individual
Prefix:MRS
First Name:ANNA CHATHAM
Middle Name:
Last Name:RIPPLE
Suffix:
Gender:F
Credentials:LPC, LCASA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 LABURNUM AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-6131
Mailing Address - Country:US
Mailing Address - Phone:336-416-2588
Mailing Address - Fax:
Practice Address - Street 1:209 DELBURG ST
Practice Address - Street 2:SUITE 105
Practice Address - City:DAVIDSON
Practice Address - State:NC
Practice Address - Zip Code:28036-6913
Practice Address - Country:US
Practice Address - Phone:704-892-8003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-21
Last Update Date:2013-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA8446101YP2500X
NC2525A101YA0400X
NC8446101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)