Provider Demographics
NPI:1487761110
Name:ANTHONY, MICHELE F (MSW, LCSW)
Entity type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:F
Last Name:ANTHONY
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 ELLINGTON OAKS CT
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-6472
Mailing Address - Country:US
Mailing Address - Phone:636-288-1997
Mailing Address - Fax:844-965-9809
Practice Address - Street 1:28 ELLINGTON OAKS CT
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-6472
Practice Address - Country:US
Practice Address - Phone:636-288-1997
Practice Address - Fax:844-965-9809
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0047511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical