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General NPI Number Information
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NPI Number | 1609092188
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Entity Type | Organization
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Legal Business Name | ANCHOR CLANKER INC
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 2051 W WHEELER AVE STE #5
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City | ARANSAS PASS
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State | TX
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Zip | 78336-4762
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Country | US
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Telephone | 361-523-8241
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Fax | 888-201-8760
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Provider Business Mailing Address
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Address Line | PO BOX 1267
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City | INGLESIDE
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State | TX
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Zip | 78362-1267
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Country | US
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Telephone | 361-238-4083
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Fax | 214-233-0329
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. JENNIFER M JONES
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Credential | MSW, LCSW, DCSW, SAP
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Telephone | 361-523-8241
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | S09573
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License Number State | TX
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