Provider Demographics
NPI:1154907111
Name:ANDERSEN, ANNA L (LPC)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:L
Last Name:ANDERSEN
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 1:5716 S KOLMAR AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60629-5310
Mailing Address - Country:US
Mailing Address - Phone:872-777-6185
Mailing Address - Fax:
Practice Address - Street 1:180 N MICHIGAN AVE STE 410
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-7488
Practice Address - Country:US
Practice Address - Phone:888-726-7170
Practice Address - Fax:312-782-8276
Is Sole Proprietor?:No
Enumeration Date:2021-03-21
Last Update Date:2021-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.013224101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional