Provider Demographics
NPI:1043536857
Name:KLOSEK, ANNA MARIA (MA, EDS, LPC, LCMHC)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:MARIA
Last Name:KLOSEK
Suffix:
Gender:F
Credentials:MA, EDS, LPC, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1307 16TH ST
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:WV
Mailing Address - Zip Code:26105-1201
Mailing Address - Country:US
Mailing Address - Phone:304-282-0354
Mailing Address - Fax:
Practice Address - Street 1:1307 16TH ST
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:WV
Practice Address - Zip Code:26105-1201
Practice Address - Country:US
Practice Address - Phone:304-282-0354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-19
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7199101Y00000X
WV2458101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor