Provider Demographics
NPI:1013348804
Name:ANN ANDERSON COUNSELING & CONSULTING LLC
Entity Type:Organization
Organization Name:ANN ANDERSON COUNSELING & CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR& CONSULTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:ANN
Authorized Official - Middle Name:STEGE
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LISW, LADAC, LPCC
Authorized Official - Phone:575-626-9727
Mailing Address - Street 1:411 E COLLEGE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:NM
Mailing Address - Zip Code:88201-7524
Mailing Address - Country:US
Mailing Address - Phone:575-626-9727
Mailing Address - Fax:
Practice Address - Street 1:1210 N MAIN ST
Practice Address - Street 2:SUITE 304
Practice Address - City:ROSWELL
Practice Address - State:NM
Practice Address - Zip Code:88201-5012
Practice Address - Country:US
Practice Address - Phone:575-626-9727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-05
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI-3021101Y00000X, 1041C0700X
NM3566101YA0400X
NM2179101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty