Provider Demographics
NPI:1558766634
Name:MENSAH, ANTHONY TECHIE (LSW, LBS)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:TECHIE
Last Name:MENSAH
Suffix:
Gender:M
Credentials:LSW, LBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 YEADON AVE
Mailing Address - Street 2:
Mailing Address - City:YEADON
Mailing Address - State:PA
Mailing Address - Zip Code:19050-3811
Mailing Address - Country:US
Mailing Address - Phone:610-284-2616
Mailing Address - Fax:484-461-1264
Practice Address - Street 1:1007 YEADON AVE
Practice Address - Street 2:833 EAST BUTLER AVE, DOYLESTOWN
Practice Address - City:YEADON
Practice Address - State:PA
Practice Address - Zip Code:19050-3811
Practice Address - Country:US
Practice Address - Phone:484-433-1784
Practice Address - Fax:484-461-1264
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-30
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH000272103K00000X
PASW01192104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No104100000XBehavioral Health & Social Service ProvidersSocial Worker