Provider Demographics
NPI:1821086125
Name:ZOLD, ANTHONY CHRISTOPHER (PHD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:CHRISTOPHER
Last Name:ZOLD
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2210 ELDRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-2109
Mailing Address - Country:US
Mailing Address - Phone:360-650-9435
Mailing Address - Fax:360-650-1341
Practice Address - Street 1:2210 ELDRIDGE AVE
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-2109
Practice Address - Country:US
Practice Address - Phone:360-650-9435
Practice Address - Fax:360-650-1341
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-11
Last Update Date:2024-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA879103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7066830Medicaid
WA8920819OtherLABOR CRIME VICTIMS
WA116827OtherLABOR & INDUSTRIES
WA7066830Medicaid