Anthony, James S

Anthony, James S is an individual health care provider with primary practice located at 4444 Centerville Road #235, White Bear Lake MN 55127-3712. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Anthony, James S can be contacted via phone (651) 289-3111.

Contact Information

Primary practice address
4444 Centerville Road #235 White Bear Lake MN 55127-3712
Phone: (651) 289-3111
Fax: (651) 426-6766
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X LP1905 Minnesota

Profile Details

NPI number 1255431243
LBN Legal business name Anthony, James S
Credentials PHD, LP
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 22nd, 2006
Last updated Jul 21st, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255431243 NPPES
Minnesota Other 103077 U CARE
Minnesota MEDICAID 202550700 U CARE
Minnesota Other 21390CE-47774AN U CARE
Minnesota Other 61-13267 U CARE

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