Provider Demographics
NPI:1033926993
Name:GENOVA, ANNIKEN LUNDE (LMHC)
Entity type:Individual
Prefix:
First Name:ANNIKEN
Middle Name:LUNDE
Last Name:GENOVA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 HIGH ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:UXBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01569-1852
Mailing Address - Country:US
Mailing Address - Phone:508-498-4728
Mailing Address - Fax:
Practice Address - Street 1:25 BIRCH ST STE A6
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-3585
Practice Address - Country:US
Practice Address - Phone:508-844-4908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-14
Last Update Date:2024-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALMHC10002012101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health