Provider Demographics
NPI:1841333838
Name:CASANOVA, ANTHIA (CAP, LMHC)
Entity type:Individual
Prefix:MS
First Name:ANTHIA
Middle Name:
Last Name:CASANOVA
Suffix:
Gender:F
Credentials:CAP, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8304 RIVERBOAT DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33637-6580
Mailing Address - Country:US
Mailing Address - Phone:813-802-2025
Mailing Address - Fax:
Practice Address - Street 1:1936 W DR MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:STE 206
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6500
Practice Address - Country:US
Practice Address - Phone:813-802-2025
Practice Address - Fax:888-357-6132
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 11051101YM0800X
FLCAP 4805101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL767925400Medicaid