Provider Demographics
NPI:1366954570
Name:QUARLES, ANTHONY DEWAYNE JR
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:DEWAYNE
Last Name:QUARLES
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 E RIVERCENTER BLVD STE 417
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41011-1612
Mailing Address - Country:US
Mailing Address - Phone:479-222-1927
Mailing Address - Fax:757-453-4358
Practice Address - Street 1:50 E RIVERCENTER BLVD STE 417
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:KY
Practice Address - Zip Code:41011-1612
Practice Address - Country:US
Practice Address - Phone:479-222-1927
Practice Address - Fax:757-453-4358
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-27
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health