Provider Demographics
NPI:1972718153
Name:CHOROST, ANNA (LPC)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:CHOROST
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:BURRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18733 DAWN RD
Mailing Address - Street 2:
Mailing Address - City:NEWALLA
Mailing Address - State:OK
Mailing Address - Zip Code:74857-8889
Mailing Address - Country:US
Mailing Address - Phone:405-802-4830
Mailing Address - Fax:
Practice Address - Street 1:18733 DAWN RD
Practice Address - Street 2:
Practice Address - City:NEWALLA
Practice Address - State:OK
Practice Address - Zip Code:74857-8889
Practice Address - Country:US
Practice Address - Phone:405-802-4830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3761101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health