Provider Demographics
NPI:1215576509
Name:NATHAL, ANTHONY ALLEN (MSW)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:ALLEN
Last Name:NATHAL
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2231 N TAYLOR RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44112-3044
Mailing Address - Country:US
Mailing Address - Phone:216-355-0365
Mailing Address - Fax:216-803-9899
Practice Address - Street 1:2231 N TAYLOR RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44112-3044
Practice Address - Country:US
Practice Address - Phone:216-355-0365
Practice Address - Fax:216-803-9899
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-03
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.18020491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical