Provider Demographics
NPI:1821409970
Name:FEERST, ANNETTE (LMFT, LPCC)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:
Last Name:FEERST
Suffix:
Gender:F
Credentials:LMFT, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6042 N FRESNO ST STE 202
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-5279
Mailing Address - Country:US
Mailing Address - Phone:559-466-9722
Mailing Address - Fax:559-343-0263
Practice Address - Street 1:6042 N FRESNO ST STE 202
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5279
Practice Address - Country:US
Practice Address - Phone:559-466-9722
Practice Address - Fax:559-343-0263
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-12
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
CAPCCI2154101YP2500X
CA105969106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1821409970Medicaid