Provider Demographics
NPI:1720970163
Name:SOARES, ANTHONE JR
Entity type:Individual
Prefix:
First Name:ANTHONE
Middle Name:
Last Name:SOARES
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 1:30 N GOULD ST STE R
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-6317
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4044 CARTHAGE RD
Practice Address - Street 2:
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21133-4428
Practice Address - Country:US
Practice Address - Phone:540-642-9493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-18
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
No174200000XOther Service ProvidersMeals
No253Z00000XAgenciesIn Home Supportive Care