Individual
VANESSA RENEE ANSTINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED., LCPC, NCC, DCC
Contact information
Practice address
1044 NORTHWEST BLVD, SUITE E 118, COEUR D ALENE, ID 83814-2114
(208) 659-0958
(877) 777-6965
Mailing address
1044 NORTHWEST BLVD, SUITE E 118, COEUR D ALENE, ID 83814-2114
(208) 659-0958
(877) 777-6965
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LCPC-314
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11834998
CAQH
—
01
—
5128563
AMERICAN COUNSELING ASSOC
—
05
—
805716700
—
ID
01
—
CRC-00014445
CERTIFIED REHAB COUNSELOR
—
01
—
DCC 1776
DISTANCE CREDENTIALED COUNSELOR - DCC
—
01
—
LCPC-314
STATE OF IDAHO
ID
01
—
NCC-64680
NATIONAL CERT. COUNSELOR
—
Enumeration date
05/10/2007
Last updated
10/18/2016
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