Healthcare Provider Details

I. General information

NPI: 1366006850
Provider Name (Legal Business Name): ANNA HARLAND LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2019
Last Update Date: 05/18/2025
Certification Date: 05/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1704 LLANO ST STE B
SANTA FE NM
87505-5415
US

IV. Provider business mailing address

PO BOX 4593
SANTA FE NM
87502-4593
US

V. Phone/Fax

Practice location:
  • Phone: 505-919-9933
  • Fax:
Mailing address:
  • Phone: 505-919-9933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberT-CTL0211561
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCTB-2022-0910
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: