Healthcare Provider Details

I. General information

NPI: 1437070299
Provider Name (Legal Business Name): ANTHONY STEVEN PREVITI LMSW, LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11630 FULTON ST E # 201
LOWELL MI
49331-9426
US

IV. Provider business mailing address

2071 SANDPIPER PT NE APT 201
GRAND RAPIDS MI
49505-6315
US

V. Phone/Fax

Practice location:
  • Phone: 630-881-9096
  • Fax:
Mailing address:
  • Phone: 630-881-9096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801122143
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: