Provider Demographics
NPI:1932648342
Name:ATTANASIO, ANTHONY F (LMHC, MCAP, QS)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:F
Last Name:ATTANASIO
Suffix:
Gender:M
Credentials:LMHC, MCAP, QS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 S FEDERAL HWY APT 13
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33460-4680
Mailing Address - Country:US
Mailing Address - Phone:561-809-4505
Mailing Address - Fax:
Practice Address - Street 1:8198 S JOG RD STE 201
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33472-6903
Practice Address - Country:US
Practice Address - Phone:561-809-4505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-17
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLADC-011398-2015101YA0400X
FLMH13208101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)