Provider Demographics
NPI:1073150504
Name:WARE, ANYA (LMT, LPC)
Entity Type:Individual
Prefix:MRS
First Name:ANYA
Middle Name:
Last Name:WARE
Suffix:
Gender:F
Credentials:LMT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 AIRPORT RD STE E
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-2610
Mailing Address - Country:US
Mailing Address - Phone:864-598-3016
Mailing Address - Fax:
Practice Address - Street 1:301 AIRPORT RD STE E
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-2610
Practice Address - Country:US
Practice Address - Phone:864-598-3016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-03
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6859101YM0800X
SC3073225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health