Provider Demographics
NPI:1316170616
Name:ANESI, JAMIE DAPHNE (LCPC)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:DAPHNE
Last Name:ANESI
Suffix:
Gender:F
Credentials:LCPC
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 974
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59624-0974
Mailing Address - Country:US
Mailing Address - Phone:406-465-6845
Mailing Address - Fax:855-722-0151
Practice Address - Street 1:323 MING PL
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-6255
Practice Address - Country:US
Practice Address - Phone:406-465-6845
Practice Address - Fax:855-722-0151
Is Sole Proprietor?:No
Enumeration Date:2009-09-02
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1444101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0000745420OtherBLUE CROSS-SHIELD OF MONTANA