Provider Demographics
NPI:1811230386
Name:KIRKLEY, ANNA L (LPC)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:L
Last Name:KIRKLEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1512 W BUSINESS LOOP 70 STE C
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65202-1323
Mailing Address - Country:US
Mailing Address - Phone:573-777-3040
Mailing Address - Fax:
Practice Address - Street 1:1512 W BUSINESS LOOP 70 STE C
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65202-1323
Practice Address - Country:US
Practice Address - Phone:573-777-3040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-02
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013008494101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO490019747Medicaid