Annita Michelle Coburn, LMFT
Individual provider Active NPI Marriage & Family Therapist · Lebanon, IN
NPI 1508465949 · NPPES record last updated Oct 17, 2020
Key facts
- NPI
- 1508465949
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 35002130A (IN)
- Practice address
- 610 N. Lebanon St.
Lebanon, IN 46052-1716 - Phone
- (765) 680-0071
- Fax
- (765) 436-0455
- NPI assigned
- Oct 17, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35002130A | IN | MD | Marriage & Family Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 35002130A | IN | Yes |
Addresses
Primary practice location
610 N. Lebanon St.
Lebanon, IN 46052-1716
Mailing address
610 N. Lebanon St.
Lebanon, IN 46052-1716
Phone (765) 680-0071
Other names
- Annita Michelle Harding
Other providers in Lebanon, IN
- Adam Anthony Cieciuch
- City Optical Co., Inc.
- Megan Clark
- Nicole C. Clark
- Samantha Cleary
- Richard Coca
- Brianna Cole
- Lisa A Conard
- Myra Rose Coomer
- Alleigh Cooper
All providers in Lebanon, IN · Marriage & Family Therapist in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 17, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.