Provider Demographics
NPI:1447611140
Name:ANAYA, ALISSA N (LMHC; LPCC)
Entity Type:Individual
Prefix:
First Name:ALISSA
Middle Name:N
Last Name:ANAYA
Suffix:
Gender:F
Credentials:LMHC; LPCC
Other - Prefix:
Other - First Name:ALISSA
Other - Middle Name:N
Other - Last Name:ANAYA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:M ED LMHC
Mailing Address - Street 1:2518 GULF GATE DR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-5731
Mailing Address - Country:US
Mailing Address - Phone:740-646-6097
Mailing Address - Fax:
Practice Address - Street 1:2518 GULF GATE DR
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-5731
Practice Address - Country:US
Practice Address - Phone:740-646-6097
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-09
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1000282101YM0800X, 101YP2500X
FLMH17892101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional