Individual
MRS. ANAIS KINEYDA MENDIETA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LCAS
Contact information
Practice address
5814 BLACKSMITH DR, RALEIGH, NC 27606-7701
(910) 644-0081
Mailing address
3350 FOOTBRIDGE LN STE 124, FAYETTEVILLE, NC 28306-9695
(910) 920-5630
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS-25246
NC
1041C0700X
Clinical Social Worker
Primary
C013650
NC
1041C0700X
Clinical Social Worker
P013128
NC
Other
Enumeration date
12/07/2018
Last updated
02/26/2026
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