Provider Demographics
NPI:1285823807
Name:LANTO, BRADLEY TODD (MSW, LCSW)
Entity Type:Individual
Prefix:MR
First Name:BRADLEY
Middle Name:TODD
Last Name:LANTO
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 MAGENS WAY
Mailing Address - Street 2:
Mailing Address - City:CEDAR POINT
Mailing Address - State:NC
Mailing Address - Zip Code:28584-8043
Mailing Address - Country:US
Mailing Address - Phone:252-241-9009
Mailing Address - Fax:
Practice Address - Street 1:1104 ARENDELL ST
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-4144
Practice Address - Country:US
Practice Address - Phone:252-241-9009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-19
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0034841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical