Provider Demographics
NPI:1982139721
Name:MARTIN BYERS, ANITA CHRISTINE (LPCA)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:CHRISTINE
Last Name:MARTIN BYERS
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 99036
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27624
Mailing Address - Country:US
Mailing Address - Phone:919-277-0253
Mailing Address - Fax:919-277-4627
Practice Address - Street 1:8368 SIX FORKS RD
Practice Address - Street 2:SUITE NUMBER 101
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27624
Practice Address - Country:US
Practice Address - Phone:919-277-0253
Practice Address - Fax:919-277-4627
Is Sole Proprietor?:No
Enumeration Date:2017-05-01
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA12732101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health