Doctor Name: | JON C ANITSAKIS |
NPI Number: | 1700148392 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC |
License Number: | 65840 |
Business Practice Address: | 2750 S 8th St Beaumont, TX - 777017719 |
Business Phone Number: | 4098391003 |
Business Fax Number: | |
Mailing Address: | 920 Edson Dr, BEAUMONT |
State: | TX |
Postal Code: | 777064509 |
Phone Number: | 4092019515 |
Fax Number: | |
NPI Enumeration Date: | 06/11/2012 |
NPI Last Update Date: | 10/04/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 65840 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |