Provider Demographics
NPI:1962631895
Name:HUTT, ANNIE B (LPC,)
Entity Type:Individual
Prefix:
First Name:ANNIE
Middle Name:B
Last Name:HUTT
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 1:3029 OLYMPIA CIR
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN
Mailing Address - State:CO
Mailing Address - Zip Code:80439-8833
Mailing Address - Country:US
Mailing Address - Phone:303-349-2619
Mailing Address - Fax:
Practice Address - Street 1:1111 WASHINGTON AVE STE 220
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-1162
Practice Address - Country:US
Practice Address - Phone:303-349-2619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-13
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4893101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional