Provider Demographics
NPI:1801265210
Name:KING, ANEESA FARZAANA (LPC)
Entity type:Individual
Prefix:MS
First Name:ANEESA
Middle Name:FARZAANA
Last Name:KING
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 1:10800 SMITHERS CT
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23238-3491
Mailing Address - Country:US
Mailing Address - Phone:843-817-2684
Mailing Address - Fax:
Practice Address - Street 1:10800 SMITHERS CT
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23238-3491
Practice Address - Country:US
Practice Address - Phone:843-817-2684
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-16
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006295101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional