Provider Demographics
NPI:1679318604
Name:CARROLL, ANNA (MS, LPC, CRC, NCC)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:CARROLL
Suffix:
Gender:F
Credentials:MS, LPC, CRC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10100 W 87TH ST STE 203
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-4628
Mailing Address - Country:US
Mailing Address - Phone:913-213-1465
Mailing Address - Fax:
Practice Address - Street 1:10100 W 87TH ST STE 203
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-4628
Practice Address - Country:US
Practice Address - Phone:913-213-1465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLPC03793101YM0800X
MO2021050553101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health