Provider Demographics
NPI:1568886976
Name:RADFORD, ANTHONY TODD (LPCC)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:TODD
Last Name:RADFORD
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 LINDA DR
Mailing Address - Street 2:
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42240-3980
Mailing Address - Country:US
Mailing Address - Phone:270-839-4576
Mailing Address - Fax:
Practice Address - Street 1:319 LINDA DR
Practice Address - Street 2:
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-3980
Practice Address - Country:US
Practice Address - Phone:270-839-4576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-06
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYLPCPCC00222207101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional