Provider Demographics
NPI:1891048674
Name:CHRISTISON, ANITA PERRY (MED, LPC)
Entity Type:Individual
Prefix:MRS
First Name:ANITA
Middle Name:PERRY
Last Name:CHRISTISON
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 667
Mailing Address - Street 2:603 WEST MAIN STREET
Mailing Address - City:WOODLAND
Mailing Address - State:NC
Mailing Address - Zip Code:27897
Mailing Address - Country:US
Mailing Address - Phone:252-209-1370
Mailing Address - Fax:252-587-0478
Practice Address - Street 1:608 JACKSON ST STE F
Practice Address - Street 2:
Practice Address - City:ROANOKE RAPIDS
Practice Address - State:NC
Practice Address - Zip Code:27870-2656
Practice Address - Country:US
Practice Address - Phone:252-308-0744
Practice Address - Fax:252-308-0092
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-18
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA9613101Y00000X
NC9613101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor