Provider Demographics
NPI:1679907026
Name:MICHAEL, ANTHONY JAMES (LMHC)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:JAMES
Last Name:MICHAEL
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2802 ORCHARD DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-5898
Mailing Address - Country:US
Mailing Address - Phone:319-268-9700
Mailing Address - Fax:319-268-1934
Practice Address - Street 1:2802 ORCHARD DR
Practice Address - Street 2:
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-5898
Practice Address - Country:US
Practice Address - Phone:319-268-9700
Practice Address - Fax:319-268-1934
Is Sole Proprietor?:No
Enumeration Date:2013-08-21
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA101YA0400X
IA001673101YM0800X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health