Individual
ANTHONY ENRIQUE ANNICCHIARICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC, LPCC, LADAC
Contact information
Practice address
1644 CARNAHAN DR, GRANTS PASS, OR 97527-4724
(541) 476-2373
Mailing address
1215 SW G ST, GRANTS PASS, OR 97526-2544
(541) 476-2373
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
12333
CA
101YP2500X
Professional Counselor
C4907
OR
101YP2500X
Professional Counselor
CCMH0170971
NM
Other
Enumeration date
07/22/2014
Last updated
04/06/2026
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