Provider Demographics
NPI:1265882583
Name:SINCOCK, ANNA JEAN (MA, LLPC)
Entity type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:JEAN
Last Name:SINCOCK
Suffix:
Gender:F
Credentials:MA, LLPC
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:JEAN
Other - Last Name:EDWARDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1813 BLANDFORD AVE SW
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:MI
Mailing Address - Zip Code:49519-1233
Mailing Address - Country:US
Mailing Address - Phone:616-928-7159
Mailing Address - Fax:
Practice Address - Street 1:1601 GALBRAITH AVE SE STE 304
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-6479
Practice Address - Country:US
Practice Address - Phone:616-541-5970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-17
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI640101548101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty