Provider Demographics
NPI:1427124759
Name:ANDERSON, PATRICIA GAY (LPC)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:GAY
Last Name:ANDERSON
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 1:2913 TILLINGHAST TRAIL
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-2814
Mailing Address - Country:US
Mailing Address - Phone:919-623-0255
Mailing Address - Fax:
Practice Address - Street 1:1071 PEMBERTON HILL ROAD
Practice Address - Street 2:201
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-9999
Practice Address - Country:US
Practice Address - Phone:919-623-0255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4100101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional