Provider Demographics
NPI:1710877733
Name:CANIESO, DEANNE CHRISTINE (LCMHC ASSOCIATE)
Entity type:Individual
Prefix:
First Name:DEANNE
Middle Name:CHRISTINE
Last Name:CANIESO
Suffix:
Gender:F
Credentials:LCMHC ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 GRADING STICK CT
Mailing Address - Street 2:
Mailing Address - City:ANGIER
Mailing Address - State:NC
Mailing Address - Zip Code:27501
Mailing Address - Country:US
Mailing Address - Phone:919-717-0169
Mailing Address - Fax:
Practice Address - Street 1:111 DENNIS DR STE 115
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-6461
Practice Address - Country:US
Practice Address - Phone:919-708-5063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA21614101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor