Provider Demographics
NPI:1811273303
Name:HALTON, TONY ANTHONY (MSSW, LADAC)
Entity type:Individual
Prefix:MR
First Name:TONY
Middle Name:ANTHONY
Last Name:HALTON
Suffix:
Gender:M
Credentials:MSSW, LADAC
Other - Prefix:MR
Other - First Name:TONY
Other - Middle Name:ANTHONY
Other - Last Name:HALTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LADAC, MSSW
Mailing Address - Street 1:223 MADISON ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MADISON
Mailing Address - State:TN
Mailing Address - Zip Code:37115-3665
Mailing Address - Country:US
Mailing Address - Phone:615-516-5675
Mailing Address - Fax:615-870-0789
Practice Address - Street 1:223 MADISON ST
Practice Address - Street 2:SUITE 100
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-3665
Practice Address - Country:US
Practice Address - Phone:615-516-5675
Practice Address - Fax:615-870-0789
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-27
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN342101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)