Provider Demographics
NPI:1831267988
Name:WINTERS, ANTHONY (LCADC, LSW)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:WINTERS
Suffix:
Gender:M
Credentials:LCADC, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:761 AVENUE A
Mailing Address - Street 2:#8
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-1949
Mailing Address - Country:US
Mailing Address - Phone:201-823-0357
Mailing Address - Fax:
Practice Address - Street 1:285 MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-3906
Practice Address - Country:US
Practice Address - Phone:201-395-4801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00026200101YA0400X
NJ44SL05213000104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker