Provider Demographics
NPI:1558585166
Name:SMITHERMAN, ANTHONY EUGENE (BS)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:EUGENE
Last Name:SMITHERMAN
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 STONEWALL ST
Mailing Address - Street 2:
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30120-3628
Mailing Address - Country:US
Mailing Address - Phone:770-386-1907
Mailing Address - Fax:770-607-0883
Practice Address - Street 1:218 STONEWALL ST
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-3628
Practice Address - Country:US
Practice Address - Phone:770-386-1907
Practice Address - Fax:770-607-0883
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)