Provider Demographics
NPI:1003294471
Name:BHAT, ANITA (PSYD,MA,LPCA)
Entity Type:Individual
Prefix:DR
First Name:ANITA
Middle Name:
Last Name:BHAT
Suffix:
Gender:F
Credentials:PSYD,MA,LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2216 S MIAMI BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-6281
Mailing Address - Country:US
Mailing Address - Phone:919-806-0497
Mailing Address - Fax:866-820-8694
Practice Address - Street 1:2216 S MIAMI BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-6281
Practice Address - Country:US
Practice Address - Phone:919-806-0497
Practice Address - Fax:866-820-8694
Is Sole Proprietor?:No
Enumeration Date:2015-05-18
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA11445101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional