Healthcare Provider Details

I. General information

NPI: 1134880792
Provider Name (Legal Business Name): ANNE MARIE PREWITT LPC ASSOCIATE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2022
Last Update Date: 01/06/2022
Certification Date: 01/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2214 EMERY ST STE 530
DENTON TX
76201-2478
US

IV. Provider business mailing address

2214 EMERY ST STE 530
DENTON TX
76201-2478
US

V. Phone/Fax

Practice location:
  • Phone: 940-215-1236
  • Fax: 940-808-1018
Mailing address:
  • Phone: 940-215-1236
  • Fax: 940-808-1018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number84285
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: