# ANNA AHLBORN CRC LCPC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609529437
- **Authorized official:** ANNA SOPHIA (OWNER)
- **Authorized official phone:** (773) 771-5651

## Contact information

- **Practice address:** 13 VALERIE RD, PORTAGE, IN 46368-1094
- **Practice address phone:** (773) 771-5651
- **Mailing address:** 13 VALERIE RD, PORTAGE, IN 46368-1094

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YP2500X | Professional Counselor | — | NULL | Yes |
| 101YP2500X | Professional Counselor | — | — | Yes |

## Other

- **Enumeration date:** 02/01/2022
- **Last updated:** 02/01/2022