Provider Demographics
NPI:1841548179
Name:XANDER, ANNA LYNN (LPC)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:LYNN
Last Name:XANDER
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 1:4610 SUNNYDALE BLVD
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16509-2238
Mailing Address - Country:US
Mailing Address - Phone:814-450-0249
Mailing Address - Fax:
Practice Address - Street 1:100 STATE ST STE 202
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16507-1454
Practice Address - Country:US
Practice Address - Phone:814-480-8797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-16
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401013215101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional