Provider Demographics
NPI:1114045309
Name:MARKO, ANNE BRAINERD (LPC, NCC)
Entity type:Individual
Prefix:MS
First Name:ANNE
Middle Name:BRAINERD
Last Name:MARKO
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2424 W WOODLAWN ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-2952
Mailing Address - Country:US
Mailing Address - Phone:484-744-0574
Mailing Address - Fax:610-740-9550
Practice Address - Street 1:402 N FULTON ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18102-2002
Practice Address - Country:US
Practice Address - Phone:610-432-3919
Practice Address - Fax:610-740-9550
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC009651101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional