Provider Demographics
NPI:1306186945
Name:PATER, ANTHONY (CADC, CCDP)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:PATER
Suffix:
Gender:M
Credentials:CADC, CCDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 266
Mailing Address - Street 2:
Mailing Address - City:HOLLIDAYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16648-0266
Mailing Address - Country:US
Mailing Address - Phone:814-935-1185
Mailing Address - Fax:814-695-2278
Practice Address - Street 1:516 ALLEGHENY ST STE 104
Practice Address - Street 2:
Practice Address - City:HOLLIDAYSBURG
Practice Address - State:PA
Practice Address - Zip Code:16648-2028
Practice Address - Country:US
Practice Address - Phone:814-935-1185
Practice Address - Fax:814-695-2278
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-19
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA077028101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)