Provider Demographics
NPI:1669845137
Name:ANNARINO, MISTY MICHELLE (LCMHC/LCAS)
Entity type:Individual
Prefix:
First Name:MISTY
Middle Name:MICHELLE
Last Name:ANNARINO
Suffix:
Gender:
Credentials:LCMHC/LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 PURRFECT VIEW DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28716-6315
Mailing Address - Country:US
Mailing Address - Phone:828-335-5895
Mailing Address - Fax:
Practice Address - Street 1:338 MAIN ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:NC
Practice Address - Zip Code:28716-4478
Practice Address - Country:US
Practice Address - Phone:828-335-5895
Practice Address - Fax:980-321-7100
Is Sole Proprietor?:No
Enumeration Date:2015-11-05
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21894101YA0400X
NC14610101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC21894OtherNC SUBSTANCE ABUSE PROFESSIONAL PRACTICE BOARD