Provider Demographics
NPI:1205136090
Name:GODIALI, ANNA MARIA (LPC)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:MARIA
Last Name:GODIALI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ADVANTAGE
Other - Middle Name:
Other - Last Name:COUNSELING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:HILLCREST COUNSELING LLC
Mailing Address - Street 2:15110 BENDING BRAE COURT
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-2681
Mailing Address - Country:US
Mailing Address - Phone:262-244-9350
Mailing Address - Fax:989-893-3528
Practice Address - Street 1:HILLCREST COUNSELING LLC
Practice Address - Street 2:15110 BENDING BRAE COURT
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-2681
Practice Address - Country:US
Practice Address - Phone:262-244-9350
Practice Address - Fax:989-893-3528
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-26
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401008740101YP2500X
WI7707-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional