Provider Demographics
NPI:1902481351
Name:ISAAC, ANITA BERNAE (LPC-A)
Entity Type:Individual
Prefix:MRS
First Name:ANITA
Middle Name:BERNAE
Last Name:ISAAC
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 COXTON MILL LN
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29073-7025
Mailing Address - Country:US
Mailing Address - Phone:803-814-2350
Mailing Address - Fax:
Practice Address - Street 1:1154 SUNNYSIDE DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-3387
Practice Address - Country:US
Practice Address - Phone:803-667-4697
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-16
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7360101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health