Provider Demographics
NPI:1023883030
Name:WRYE, ANNASTHASIA (MA, LPC)
Entity type:Individual
Prefix:
First Name:ANNASTHASIA
Middle Name:
Last Name:WRYE
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:ANNASTHASIA
Other - Middle Name:
Other - Last Name:CORBIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:122 STONE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:PHILIPSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16866-8943
Mailing Address - Country:US
Mailing Address - Phone:240-587-0149
Mailing Address - Fax:
Practice Address - Street 1:122 STONE RIDGE RD
Practice Address - Street 2:
Practice Address - City:PHILIPSBURG
Practice Address - State:PA
Practice Address - Zip Code:16866-8943
Practice Address - Country:US
Practice Address - Phone:240-587-0149
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC016446101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health