Healthcare Provider Details

I. General information

NPI: 1477448629
Provider Name (Legal Business Name): ANTHONY SASSO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2025
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4034 N HAMPTON DR
POWELL OH
43065-8445
US

IV. Provider business mailing address

4034 N HAMPTON DR
POWELL OH
43065-8445
US

V. Phone/Fax

Practice location:
  • Phone: 201-927-9061
  • Fax:
Mailing address:
  • Phone: 201-927-9061
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberC.2507029
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: