Healthcare Provider Details

I. General information

NPI: 1134390339
Provider Name (Legal Business Name): ANNE ALLANKETNER MA LPC MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2008
Last Update Date: 03/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 VIEW LN
EUGENE OR
97405-2314
US

IV. Provider business mailing address

3400 VIEW LN
EUGENE OR
97405-2314
US

V. Phone/Fax

Practice location:
  • Phone: 541-343-3062
  • Fax:
Mailing address:
  • Phone: 541-343-3062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC C1976
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC 18959
License Number StateCA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: