Provider Demographics
NPI:1851330575
Name:SCHIMIZZI, ANITA MARIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANITA
Middle Name:MARIE
Last Name:SCHIMIZZI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:624 BAYBERRY DR
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-9121
Mailing Address - Country:US
Mailing Address - Phone:919-323-5428
Mailing Address - Fax:919-967-7464
Practice Address - Street 1:310 KILDAIRE RD
Practice Address - Street 2:SUITE 106
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27516-4407
Practice Address - Country:US
Practice Address - Phone:919-323-5428
Practice Address - Fax:919-967-7464
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2888103TC2200X, 103TB0200X, 103TF0000X, 103T00000X
NC103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6000682Medicaid