Provider Demographics
NPI:1205141389
Name:ELDERKIN, ANITA (LCPC)
Entity type:Individual
Prefix:MS
First Name:ANITA
Middle Name:
Last Name:ELDERKIN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:671 E RIVERPARK LN
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83706-4066
Mailing Address - Country:US
Mailing Address - Phone:208-338-4699
Mailing Address - Fax:
Practice Address - Street 1:671 E RIVERPARK LN
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706-4066
Practice Address - Country:US
Practice Address - Phone:208-344-2071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-12
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC-5122101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health