Provider Demographics
NPI:1427811876
Name:HEBBERT, ANNA L (MSW, PCLS)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:L
Last Name:HEBBERT
Suffix:
Gender:F
Credentials:MSW, PCLS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 W YELLOWSTONE HWY STE 100
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-7509
Mailing Address - Country:US
Mailing Address - Phone:307-233-4276
Mailing Address - Fax:
Practice Address - Street 1:535 W YELLOWSTONE HWY STE 100
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-7509
Practice Address - Country:US
Practice Address - Phone:307-233-4276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY11411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical