Individual provider Active NPI

Anna Resnick, PHD

  • Psychologist
  • Candler, NC
National Provider Identifier
1043309230
Registry record updated Apr 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
5410 Issued in NC
Practice address
32 Buckhorn Gap Rd
Candler, NC 28715-0230
Phone
(203) 887-6040
Fax
(828) 633-0572
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 002113 CT
Clinical Psychologist 103TC0700X 5410 NC
Psychologist 103T00000X 5410 NC Primary

Addresses

Primary practice location

32 Buckhorn Gap Rd
Candler, NC 28715-0230

Mailing address

32 Buckhorn Gap Rd
Candler, NC 28715-0230
Phone (203) 887-6040

Other identifiers 1

IdentifierTypeStateIssuer
060002113CT03OtherANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181106000497 NC Practitioner - Clinical Psychologist 1052590585 Reassigns benefits to 1 organization
Practice locations: Candler, NC

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
002113CTMDClinical Psychologist
2113CTMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Anna Resnick CurrentSince Mar 28, 2025 Accepting new patients
Lifesource of North Carolina Clinical CurrentSince Sep 1, 2018 Accepting new patients
Lifesource of North Carolina Psychologist CurrentSince Sep 1, 2018 Accepting new patients

Locations

3205 Randall Pkwy
Ste 105
Wilmington, NC 28403
Phone (910) 338-2880

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1043309230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 BUCKHORN GAP RD",
            "city": "CANDLER",
            "state": "NC",
            "postal_code": "287150230",
            "telephone_number": "203-887-6040",
            "fax_number": "828-613-0572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 BUCKHORN GAP RD",
            "city": "CANDLER",
            "state": "NC",
            "postal_code": "287150230",
            "telephone_number": "203-887-6040",
            "fax_number": "828-633-0572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RESNICK",
        "first_name": "ANNA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "002113",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "5410",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "5410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "060002113CT03",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Candler, NC

Sources for this page

Verify at the official NPI Registry.