Provider Demographics
NPI:1750798831
Name:ANAYA, ANA
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:
Last Name:ANAYA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:0N413 KIMBALL RD
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60190-1805
Mailing Address - Country:US
Mailing Address - Phone:714-467-8847
Mailing Address - Fax:
Practice Address - Street 1:28W671 GARYS MILL RD
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190-1564
Practice Address - Country:US
Practice Address - Phone:630-293-9860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-21
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180014920101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL180014920OtherLICENSED CLINICAL PROFESSIONAL COUNSELOR
IL178016729OtherLICENSED PROFESSIONAL COUNSELOR