Provider Demographics
NPI:1285756718
Name:MCCORD, ANNE C (LMFT)
Entity type:Individual
Prefix:MS
First Name:ANNE
Middle Name:C
Last Name:MCCORD
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1292
Mailing Address - Street 2:
Mailing Address - City:HONOKAA
Mailing Address - State:HI
Mailing Address - Zip Code:96727-1292
Mailing Address - Country:US
Mailing Address - Phone:808-775-9443
Mailing Address - Fax:808-775-9443
Practice Address - Street 1:101 AUPUNI ST
Practice Address - Street 2:SUITE 108
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-4246
Practice Address - Country:US
Practice Address - Phone:808-640-7615
Practice Address - Fax:808-775-9443
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI102106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000596817OtherHMSA