Provider Demographics
NPI:1972836021
Name:CHEN, ANTHONY BENJAMIN (MED, LPC)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:BENJAMIN
Last Name:CHEN
Suffix:
Gender:M
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5827 NW LOOP 410 APT 1014
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78238-2511
Mailing Address - Country:US
Mailing Address - Phone:210-320-0949
Mailing Address - Fax:
Practice Address - Street 1:803 CASTROVILLE RD STE 413
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78237-3148
Practice Address - Country:US
Practice Address - Phone:210-436-2339
Practice Address - Fax:210-436-2329
Is Sole Proprietor?:No
Enumeration Date:2009-09-08
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX60259101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional