Provider Demographics
NPI:1285304360
Name:CRISPO, ANNE (LPCC)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:CRISPO
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7975 SHIPLEY RD
Mailing Address - Street 2:
Mailing Address - City:CULVER
Mailing Address - State:MN
Mailing Address - Zip Code:55779-8049
Mailing Address - Country:US
Mailing Address - Phone:218-393-3947
Mailing Address - Fax:
Practice Address - Street 1:1702 MILLER TRUNK HWY STE 209
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55811-4448
Practice Address - Country:US
Practice Address - Phone:218-524-8889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-20
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC02952101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health