Healthcare Provider Details

I. General information

NPI: 1790067916
Provider Name (Legal Business Name): ANITA FERRELL PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2011
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 VILLAGE PL STE 203
DILLON CO
80435-6034
US

IV. Provider business mailing address

PO BOX 512
FRISCO CO
80443-0512
US

V. Phone/Fax

Practice location:
  • Phone: 406-270-0054
  • Fax:
Mailing address:
  • Phone: 970-333-6800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSYC.00016334
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: