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General NPI Number Information
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NPI Number | 1568701167
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Entity Type | Individual
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Provider Name | ANNE M CHRISOULIS LPC-S, LMFT
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Gender | Female
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Dates
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Enumeration Date | 02/04/2013
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Last Update Date | 05/10/2021
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Provider Practice Location Address
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Address Line | 522 CLARENCE ST
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City | LAKE CHARLES
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State | LA
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Zip | 70601
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Country | US
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Telephone | 337-214-3544
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Fax |
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Provider Business Mailing Address
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Address Line | 3725 LAKE ST
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City | LAKE CHARLES
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State | LA
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Zip | 70605-2643
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Country | US
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Telephone | 337-214-3544
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 67981
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2016
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 356
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License Number State | LA
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