Provider Demographics
NPI:1578698288
Name:NEGRON, ANTHONY ALLEN (LCSW)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:ALLEN
Last Name:NEGRON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 MUIRS CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-6173
Mailing Address - Country:US
Mailing Address - Phone:336-355-6551
Mailing Address - Fax:336-834-0442
Practice Address - Street 1:204 MUIRS CHAPEL RD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-6173
Practice Address - Country:US
Practice Address - Phone:336-355-6551
Practice Address - Fax:336-834-0442
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0121291041C0700X
225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner