Provider Demographics
NPI:1396295499
Name:BAKAS, EFSTASIA HAMBERIS (LPC)
Entity type:Individual
Prefix:MRS
First Name:EFSTASIA
Middle Name:HAMBERIS
Last Name:BAKAS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:STACY
Other - Middle Name:
Other - Last Name:BAKAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:2239 BLASS DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29505-6479
Mailing Address - Country:US
Mailing Address - Phone:843-601-1186
Mailing Address - Fax:
Practice Address - Street 1:525 S DARGAN ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-2549
Practice Address - Country:US
Practice Address - Phone:843-407-5419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-12
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6443101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor