Healthcare Provider Details

I. General information

NPI: 1174367494
Provider Name (Legal Business Name): ANNA PROFIO KOONTS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANNA PROFIO MSW, LCSWA

II. Dates (important events)

Enumeration Date: 06/21/2024
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

379 NEW MARKET BLVD STE 2A
BOONE NC
28607-3765
US

IV. Provider business mailing address

PO BOX 1536
MORGANTON NC
28680-1536
US

V. Phone/Fax

Practice location:
  • Phone: 919-353-4090
  • Fax:
Mailing address:
  • Phone: 828-437-3000
  • Fax: 828-437-4999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: