Provider Demographics
NPI:1255097796
Name:WEIGLE, ANNA (LCMHC)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:WEIGLE
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 294
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-0294
Mailing Address - Country:US
Mailing Address - Phone:603-322-1367
Mailing Address - Fax:802-633-6759
Practice Address - Street 1:800 PARK AVE RM 101
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-1513
Practice Address - Country:US
Practice Address - Phone:603-322-1367
Practice Address - Fax:802-633-6759
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-09
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0017050101YP2500X
NH2412101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional