Provider Demographics
NPI:1750769519
Name:ANSON, LINDA SUSAN (LPC)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:SUSAN
Last Name:ANSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1693 QUENTIN ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-2518
Mailing Address - Country:US
Mailing Address - Phone:877-999-0538
Mailing Address - Fax:720-848-3050
Practice Address - Street 1:1693 QUENTIN ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2518
Practice Address - Country:US
Practice Address - Phone:877-999-0538
Practice Address - Fax:720-848-3050
Is Sole Proprietor?:No
Enumeration Date:2015-05-13
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0004008101YA0400X
AZ12513101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health