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General NPI Number Information
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NPI Number | 1962737882
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Entity Type | Individual
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Provider Name | ANNA REBECCA GRIES B.A, MA, LPC, LCMHC
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Gender | Female
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Dates
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Enumeration Date | 10/09/2009
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 21 GRANDVIEW TER
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City | RUTLAND
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State | VT
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Zip | 05701-3748
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Country | US
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Telephone | 631-766-7897
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Fax |
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Provider Business Mailing Address
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Address Line | 21 GRANDVIEW TER
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City | RUTLAND
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State | VT
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Zip | 05701-3748
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Country | US
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Telephone | 631-766-7897
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0011172
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 068.0134465
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License Number State | VT
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