Provider Demographics
NPI:1205174299
Name:CULLIFER, ANNA MARIE (LPC)
Entity type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:MARIE
Last Name:CULLIFER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:ANNA
Other - Middle Name:MARIE
Other - Last Name:AMREIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:301 W MONROE ST
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:MO
Mailing Address - Zip Code:65275-1348
Mailing Address - Country:US
Mailing Address - Phone:573-567-0399
Mailing Address - Fax:573-440-1130
Practice Address - Street 1:301 W MONROE ST
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:MO
Practice Address - Zip Code:65275-1348
Practice Address - Country:US
Practice Address - Phone:573-567-0399
Practice Address - Fax:573-440-1130
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-25
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013002019101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional