Provider Demographics
NPI:1912529595
Name:MAHR, ANNA COLEEN (LCPC)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:COLEEN
Last Name:MAHR
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 SNAPDRAGON DR
Mailing Address - Street 2:
Mailing Address - City:FINKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21048-2137
Mailing Address - Country:US
Mailing Address - Phone:410-292-5007
Mailing Address - Fax:
Practice Address - Street 1:9700 OLD HARFORD RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21234-1140
Practice Address - Country:US
Practice Address - Phone:410-292-5007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-18
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC10367101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional