Johnny Anthony Sr., SOCIAL WORKER

Individual provider Active NPI Clinical Social Worker · Tuskegee, AL

NPI 1942961867 · NPPES record last updated Jan 4, 2022

Key facts

NPI
1942961867
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
5368G (AL)
Practice address
2400 Hospital Rd
Tuskegee, AL 36083-5001
Phone
(334) 727-0550
NPI assigned
Jan 3, 2022
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
5368GALMDClinical Social Worker
5668GALMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 5668G AL
Clinical Social Worker 1041C0700X 5368G AL Yes

Addresses

Primary practice location

2400 Hospital Rd
Tuskegee, AL 36083-5001

Mailing address

2400 Hospital Rd
Tuskegee, AL 36083-5001
Phone (334) 727-0550

Other identifiers

IdentifierTypeStateIssuer
5368GOtherALSOCIAL WORK

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL Computer Direct

Other providers in Tuskegee, AL

All providers in Tuskegee, AL · Clinical Social Worker in Alabama

Sources for this page

Verify at the official NPI Registry.