Provider Demographics
NPI:1477760064
Name:PIAZZA, ANNE D (LPC, NCC, NCSC, RTC)
Entity type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:D
Last Name:PIAZZA
Suffix:
Gender:F
Credentials:LPC, NCC, NCSC, RTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 CHERRY LAUREL LN
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-8623
Mailing Address - Country:US
Mailing Address - Phone:601-941-8188
Mailing Address - Fax:
Practice Address - Street 1:HIGHLAND VILLAGE 4500 I-55 NORTH SUITE 220
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39211
Practice Address - Country:US
Practice Address - Phone:601-941-8188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS0856101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional