Provider Demographics
NPI:1457953465
Name:BAILEY, ANITA HOUNSHELL (LPC)
Entity Type:Individual
Prefix:MRS
First Name:ANITA
Middle Name:HOUNSHELL
Last Name:BAILEY
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 1:31422 BIG PINE RD
Mailing Address - Street 2:
Mailing Address - City:PAINTER
Mailing Address - State:VA
Mailing Address - Zip Code:23420-4326
Mailing Address - Country:US
Mailing Address - Phone:757-709-9260
Mailing Address - Fax:
Practice Address - Street 1:15440 KINGS STREET
Practice Address - Street 2:
Practice Address - City:BELLE HAVEN
Practice Address - State:VA
Practice Address - Zip Code:23306
Practice Address - Country:US
Practice Address - Phone:757-709-9260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-13
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701010098101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0701010098OtherBOARD OF COUNSELING