MEDICARE: MS. ANTHIA CASANOVA CAP, LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MH 11051	FL
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	CAP 4805	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841333838
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANTHIA CASANOVA CAP, LMHC

Provider Business Mailing Address
First Line	:	8304 RIVERBOAT DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33637-6580
Country	:	US
Telephone Number	:	813-802-2025
Fax Number	:

Provider Business Practice Location Address
First Line	:	1936 W DR MARTIN LUTHER KING JR BLVD
Second Line	:	STE 206
City	:	TAMPA
State	:	FL
Zip	:	33607-6500
Country	:	US
Telephone Number	:	813-802-2025
Fax Number	:	888-357-6132

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2007
Last Update Date	:	09/04/2014

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