Provider Demographics
NPI:1851869259
Name:CHITLURI, ANANTA LAKSHMI MANASA (MED)
Entity Type:Individual
Prefix:
First Name:ANANTA LAKSHMI
Middle Name:MANASA
Last Name:CHITLURI
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 KIERNAN CHOICE
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-5537
Mailing Address - Country:US
Mailing Address - Phone:919-909-4359
Mailing Address - Fax:
Practice Address - Street 1:101 KIERNAN CHOICE
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-5537
Practice Address - Country:US
Practice Address - Phone:919-909-4359
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-05
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA14460101YM0800X, 101YP2500X
NC14460101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional