Annetta Jean Anderson, MA, NCC, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

1999140206 Issued in MO

Practice address

304 W Erie St Ste a
Springfield, MO 65807-4915

Phone

(417) 881-7151

NPI assigned

Sep 12, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189555200000",
    "number": "1740475615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4891 W FARM ROAD 146",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658029370",
            "telephone_number": "417-881-7151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 W ERIE ST STE A",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658074915",
            "telephone_number": "417-881-7151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ANNETTA",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "MA, NCC, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-12",
        "last_updated": "2007-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "1999140206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Richter Nutrition LLC
• Neesha Anand, M.D.
• Rajamanikkam Anandarajah, MD
• Martin Mazen Anbari, M.D.
• Bethany Susanne Anders, DMD
• Ashlie Joy Anderson, LPN
• Ashlyn Anderson
• Cody John Anderson, DO
• Daphne K Anderson, MD
• David A Anderson, MD

• Professional Counselor in Springfield, MO
• Providers in Springfield, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.