Healthcare Provider Details

I. General information

NPI: 1801710975
Provider Name (Legal Business Name): ANNA CLAIRE ANDERSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 WEST MAIN STREET SUITE 3
BEULAH ND
58523
US

IV. Provider business mailing address

257 1ST ST E STE 3
DICKINSON ND
58601-5267
US

V. Phone/Fax

Practice location:
  • Phone: 701-300-1534
  • Fax:
Mailing address:
  • Phone: 701-300-1534
  • Fax: 701-660-1601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1572-8-1-26A
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: