Provider Demographics
NPI:1952844011
Name:PANTELOPULOS, ANASTASIOS ANTHONY (LCMHC)
Entity Type:Individual
Prefix:MR
First Name:ANASTASIOS
Middle Name:ANTHONY
Last Name:PANTELOPULOS
Suffix:
Gender:M
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:5 ALPINE WAY
Mailing Address - Street 2:
Mailing Address - City:SWANNANOA
Mailing Address - State:NC
Mailing Address - Zip Code:28778-2301
Mailing Address - Country:US
Mailing Address - Phone:610-299-9204
Mailing Address - Fax:844-464-0860
Practice Address - Street 1:5 ALPINE WAY
Practice Address - Street 2:
Practice Address - City:SWANNANOA
Practice Address - State:NC
Practice Address - Zip Code:28778-2301
Practice Address - Country:US
Practice Address - Phone:828-707-4274
Practice Address - Fax:444-640-8608
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-22
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11657101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional