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General NPI Number Information
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NPI Number | 1184208670
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Entity Type | Individual
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Provider Name | ANTHONY CARDON LLMSW
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Gender | Male
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Dates
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Enumeration Date | 05/10/2021
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Last Update Date | 12/15/2024
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Provider Practice Location Address
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Address Line | 25600 WOODWARD AVE STE 215
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City | ROYAL OAK
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State | MI
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Zip | 48067-0945
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Country | US
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Telephone | 248-399-7447
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Fax |
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Provider Business Mailing Address
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Address Line | 1403 KIRTS BLVD APT 201
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City | TROY
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State | MI
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Zip | 48084-4310
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Country | US
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Telephone | 734-271-3526
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6851117519
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License Number State | MI
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