Provider Demographics
NPI:1588452999
Name:WHITEHURST, ANYA
Entity type:Individual
Prefix:
First Name:ANYA
Middle Name:
Last Name:WHITEHURST
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:923 WOODLAND RD
Mailing Address - Street 2:
Mailing Address - City:CREEDMOOR
Mailing Address - State:NC
Mailing Address - Zip Code:27522-8353
Mailing Address - Country:US
Mailing Address - Phone:919-360-7467
Mailing Address - Fax:
Practice Address - Street 1:15000 WESTON PKWY STE 165
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-2118
Practice Address - Country:US
Practice Address - Phone:919-268-8054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-26
Last Update Date:2025-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician