Provider Demographics
NPI:1316035793
Name:CONTI, ANTHONY H JR (LMHC)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:H
Last Name:CONTI
Suffix:JR
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 1:1962 E EDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33803-3471
Mailing Address - Country:US
Mailing Address - Phone:863-686-9905
Mailing Address - Fax:863-686-5855
Practice Address - Street 1:1962 E EDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-3471
Practice Address - Country:US
Practice Address - Phone:863-686-9905
Practice Address - Fax:863-686-5855
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH297101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH297OtherSTATE LICENSE