MEDICARE: ANNA FARMER CRADC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1164371258
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA FARMER CRADC

Provider Business Mailing Address
First Line	:	214 W LAFAYETTE ST
Second Line	:
City	:	EL DORADO SPRINGS
State	:	MO
Zip	:	64744-1434
Country	:	US
Telephone Number	:	417-448-6488
Fax Number	:

Provider Business Practice Location Address
First Line	:	2101 N ASH ST
Second Line	:
City	:	NEVADA
State	:	MO
Zip	:	64772-1082
Country	:	US
Telephone Number	:	417-448-6488
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/22/2026
Last Update Date	:	01/22/2026

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Directions to “ ANNA FARMER CRADC” Practice Location

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