Provider Demographics
NPI:1477877579
Name:ANARDI, CHRYSTAL MARIE (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:CHRYSTAL
Middle Name:MARIE
Last Name:ANARDI
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:CHRYSTAL
Other - Middle Name:MARIE
Other - Last Name:HODGSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:2003 KOOTENAI HEALTH WAY
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-6051
Mailing Address - Country:US
Mailing Address - Phone:208-625-3700
Mailing Address - Fax:208-625-3701
Practice Address - Street 1:1300 E MULLAN AVE STE 1800
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-6052
Practice Address - Country:US
Practice Address - Phone:208-625-3700
Practice Address - Fax:208-625-3701
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-17
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW321801041C0700X
WALW606192241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1477877579Medicaid