Provider Demographics
NPI:1821319641
Name:ANNA, CAROLYN F (LPC)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:F
Last Name:ANNA
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 1:6620 TAMARAX CT
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-9582
Mailing Address - Country:US
Mailing Address - Phone:970-222-9911
Mailing Address - Fax:970-613-0066
Practice Address - Street 1:6620 TAMARAX CT
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-9582
Practice Address - Country:US
Practice Address - Phone:970-222-9911
Practice Address - Fax:970-613-0066
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-15
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO978101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO13145Medicaid