Provider Demographics
NPI:1942845714
Name:HESS, ANNAMARIE KATHLEEN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ANNAMARIE
Middle Name:KATHLEEN
Last Name:HESS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ANNAMARIE
Other - Middle Name:KATHLEEN
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:126 PARK PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:RED BUD
Mailing Address - State:IL
Mailing Address - Zip Code:62278-1084
Mailing Address - Country:US
Mailing Address - Phone:573-883-0372
Mailing Address - Fax:
Practice Address - Street 1:126 PARK PLAZA DR
Practice Address - Street 2:
Practice Address - City:RED BUD
Practice Address - State:IL
Practice Address - Zip Code:62278-1084
Practice Address - Country:US
Practice Address - Phone:573-883-0372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-15
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20170363491041C0700X
IL1490212171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical