MEDICARE: DR. ANNE COWICK HAMPSON D.MIN., LCPC

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	101YM0800X	Mental Health Counselor	180.006316	IL

General Provider Information

NPI Number	:	1801010137
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANNE COWICK HAMPSON D.MIN., LCPC

Provider Business Mailing Address
First Line	:	77 W WASHINGTON ST
Second Line	:	200
City	:	CHICAGO
State	:	IL
Zip	:	60602-2801
Country	:	US
Telephone Number	:	248-933-5152
Fax Number	:	312-236-4106

Provider Business Practice Location Address
First Line	:	77 W WASHINGTON ST
Second Line	:	200
City	:	CHICAGO
State	:	IL
Zip	:	60602-2801
Country	:	US
Telephone Number	:	248-933-5152
Fax Number	:	312-236-4106

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

Provider Enumeration Date	:	04/11/2007
Last Update Date	:	02/22/2013

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