Provider Demographics
NPI:1083445928
Name:MOTT, ANNA MARGARET (CIT)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:MARGARET
Last Name:MOTT
Suffix:
Gender:F
Credentials:CIT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7705 N JEFFERSON PLACE CIR APT G
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-8623
Mailing Address - Country:US
Mailing Address - Phone:318-366-5115
Mailing Address - Fax:
Practice Address - Street 1:7384 JOHN LEBLANC BLVD
Practice Address - Street 2:
Practice Address - City:SORRENTO
Practice Address - State:LA
Practice Address - Zip Code:70778-3231
Practice Address - Country:US
Practice Address - Phone:225-300-4850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LACIT-5821101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)