Healthcare Provider Details

I. General information

NPI: 1912818188
Provider Name (Legal Business Name): ATTACHMENT & FAMILY THERAPY CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 W COLLEGE ST STE 116
SPRINGFIELD MO
65806-1201
US

IV. Provider business mailing address

600 W COLLEGE ST STE 116
SPRINGFIELD MO
65806-1201
US

V. Phone/Fax

Practice location:
  • Phone: 417-881-7151
  • Fax:
Mailing address:
  • Phone: 417-881-7151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: ANNETTA JEAN ANDERSON
Title or Position: OWNER/PSYCHOTHERAPIST
Credential: MA, NCC, LPC
Phone: 417-881-7151