Provider Demographics
NPI:1003689381
Name:ANXIETY TREATMENT SPECIALISTS
Entity Type:Organization
Organization Name:ANXIETY TREATMENT SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:
Authorized Official - Last Name:WEADOCK
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LMSW, LICSW
Authorized Official - Phone:231-668-2970
Mailing Address - Street 1:7901 4TH ST N # 17648
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-4305
Mailing Address - Country:US
Mailing Address - Phone:239-376-1953
Mailing Address - Fax:
Practice Address - Street 1:7901 4TH ST N # 17648
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-4305
Practice Address - Country:US
Practice Address - Phone:239-376-1953
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health