Provider Demographics
NPI:1336152875
Name:DANNER, ANNE (LPC, DCC)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:DANNER
Suffix:
Gender:F
Credentials:LPC, DCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3626 LANTERN CREST CV
Mailing Address - Street 2:
Mailing Address - City:SCOTTDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30079-1896
Mailing Address - Country:US
Mailing Address - Phone:404-281-6412
Mailing Address - Fax:
Practice Address - Street 1:3626 LANTERN CREST CV
Practice Address - Street 2:
Practice Address - City:SCOTTDALE
Practice Address - State:GA
Practice Address - Zip Code:30079-1896
Practice Address - Country:US
Practice Address - Phone:404-281-6412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2015-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC001831101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA410971071AMedicaid