Provider Demographics
NPI:1174883706
Name:KREN, ANTHONY EDWARD (LCSW)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:EDWARD
Last Name:KREN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 MOULTON LN
Mailing Address - Street 2:
Mailing Address - City:HEBER CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84032-3842
Mailing Address - Country:US
Mailing Address - Phone:435-503-0007
Mailing Address - Fax:
Practice Address - Street 1:360 MOULTON LN
Practice Address - Street 2:
Practice Address - City:HEBER CITY
Practice Address - State:UT
Practice Address - Zip Code:84032-3842
Practice Address - Country:US
Practice Address - Phone:435-503-0007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-16
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT136547-3501103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst