Individual
ANTHONY WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCDC
Contact information
Practice address
2709 17TH ST S, ST PETERSBURG, FL 33712-3603
(512) 731-4947
Mailing address
2709 17TH ST S, ST PETERSBURG, FL 33712-3603
(512) 731-4947
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
4280 A
FL
101YA0400X
Addiction (Substance Use Disorder) Counselor
8262
TX
101YA0400X
Addiction (Substance Use Disorder) Counselor
901
GA
225700000X
Massage Therapist
MT105186
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
105186
LMT
TX
01
—
4280 A
CAC
FL
01
—
8262
LCDC
TX
01
—
901
CADC-I
GA
Enumeration date
02/18/2016
Last updated
02/19/2016
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