Provider Demographics
NPI:1366466229
Name:ANTHONY, ROBERT E (MSW)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:E
Last Name:ANTHONY
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6220 S LINDBERGH BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63123-7839
Mailing Address - Country:US
Mailing Address - Phone:314-780-2132
Mailing Address - Fax:314-894-2942
Practice Address - Street 1:6220 S LINDBERGH BLVD STE 201
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63123-7839
Practice Address - Country:US
Practice Address - Phone:314-780-2132
Practice Address - Fax:314-894-2942
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2018-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0023131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO775580155Medicare ID - Type Unspecified