Provider Demographics
NPI:1770136764
Name:CAZZELL, ANNE ALLEN (LMHC)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:ALLEN
Last Name:CAZZELL
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 MEMORIAL DR APT 502
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-4907
Mailing Address - Country:US
Mailing Address - Phone:419-420-4065
Mailing Address - Fax:
Practice Address - Street 1:5 SACRAMENTO ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-1812
Practice Address - Country:US
Practice Address - Phone:617-354-1519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-19
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11011101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health