Individual
MR. JERMAINE ANTHONY SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW,CRADC, DOT-SAP
Contact information
Practice address
8892 LOUISANA STREET, SUITE D-2, MERRILLVILLE, IN 46410-4641
(630) 677-0450
(314) 431-6420
Mailing address
PO BOX 2964, EAST CHICAGO, IN 46312-7964
(630) 677-0450
(314) 431-6420
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
31221
IL
1041C0700X
Clinical Social Worker
Primary
149.028647
IL
Other
Enumeration date
02/08/2017
Last updated
01/29/2025
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