Provider Demographics
NPI:1669615100
Name:HOUSTON, ANTHONY P (LICSW LMHC CDP MAC)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:P
Last Name:HOUSTON
Suffix:
Gender:M
Credentials:LICSW LMHC CDP MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33440 1ST WAY S
Mailing Address - Street 2:SUITE 202
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6222
Mailing Address - Country:US
Mailing Address - Phone:253-709-9131
Mailing Address - Fax:
Practice Address - Street 1:33440 1ST WAY S
Practice Address - Street 2:SUITE 202
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6222
Practice Address - Country:US
Practice Address - Phone:253-709-9131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-14
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP00003698101YA0400X
WALH00010663101YM0800X
WALW000093261041C0700X
IDLCSW-298221041C0700X
IDNAADAC MAC # 507277101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health