Provider Demographics
NPI:1548538903
Name:NIGRO, ANTHONY GEORGE JR (LMHC)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:GEORGE
Last Name:NIGRO
Suffix:JR
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 GIRDLE RD
Mailing Address - Street 2:
Mailing Address - City:EAST AURORA
Mailing Address - State:NY
Mailing Address - Zip Code:14052-1205
Mailing Address - Country:US
Mailing Address - Phone:716-655-0528
Mailing Address - Fax:
Practice Address - Street 1:4711 TRANSIT RD
Practice Address - Street 2:FORESTREAM PLAZA SUITE 3
Practice Address - City:DEPEW
Practice Address - State:NY
Practice Address - Zip Code:14043-4888
Practice Address - Country:US
Practice Address - Phone:716-706-5921
Practice Address - Fax:716-706-5923
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-13
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004977-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health