Provider Demographics
NPI:1396710802
Name:ISBELL, ANETIA KAY (LPC, CRC, BSW, CHT)
Entity type:Individual
Prefix:MRS
First Name:ANETIA
Middle Name:KAY
Last Name:ISBELL
Suffix:
Gender:F
Credentials:LPC, CRC, BSW, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19172 DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48240-2626
Mailing Address - Country:US
Mailing Address - Phone:313-587-3363
Mailing Address - Fax:
Practice Address - Street 1:11111 HALL RD
Practice Address - Street 2:SUITE 400
Practice Address - City:UTICA
Practice Address - State:MI
Practice Address - Zip Code:48317-5711
Practice Address - Country:US
Practice Address - Phone:586-997-3153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-18
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI640100698101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional