Provider Demographics
NPI:1013176502
Name:MCMILLAN, ANITA S (LPC)
Entity Type:Individual
Prefix:MRS
First Name:ANITA
Middle Name:S
Last Name:MCMILLAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 BERRY RD
Mailing Address - Street 2:
Mailing Address - City:BANNER ELK
Mailing Address - State:NC
Mailing Address - Zip Code:28604-9651
Mailing Address - Country:US
Mailing Address - Phone:828-963-2832
Mailing Address - Fax:828-963-6840
Practice Address - Street 1:701 BERRY RD
Practice Address - Street 2:
Practice Address - City:BANNER ELK
Practice Address - State:NC
Practice Address - Zip Code:28604-9651
Practice Address - Country:US
Practice Address - Phone:828-963-2832
Practice Address - Fax:828-963-6840
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3078101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor