Anthony K Willis, PSS

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

2024-12086-01 Issued in NC

Practice address

1709 Belmar Dr
Gastonia, NC 28052-5119

Phone

(910) 391-0608

NPI assigned

Nov 14, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Cedric Dean Holdings Inc.

  dba Cedric Dean Homes

  • Community/Behavioral Health Agency
  • Charlotte, NC
  • NPI 1497473086
  NPD

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

{
    "created_epoch": "1731542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771200000000",
    "number": "1972327120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1709 BELMAR DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280525119",
            "telephone_number": "910-391-0608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1709 BELMAR DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280525119",
            "telephone_number": "910-391-0608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "ANTHONY",
        "middle_name": "K",
        "credential": "PSS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-11-14",
        "last_updated": "2026-02-16",
        "certification_date": "2026-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NC",
            "license": "2024-12086-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yvette C Williams, LCSW
• Allodia Dezeree Williamson
• Christiauna S Williamson Sr.
• Patrice S Williamson, PHARM.D
• Allison Willis, LCMHC
• Melinda Willison
• Felicity Willocks, RBT
• Willow Counseling and Wellness PLLC
• Penny Willyoung, RN
• Antigone Wilson, LCASA

• Peer Specialist in Gastonia, NC
• Providers in Gastonia, NC by specialty
• Peer Specialist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.