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General NPI Number Information
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NPI Number | 1548135916
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Entity Type | Individual
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Provider Name | ANTHONY YANIS LADAC II
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Gender | Male
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Dates
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Enumeration Date | 10/07/2025
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 8 CADILLAC DR STE 300
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City | BRENTWOOD
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State | TN
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Zip | 37027-5337
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Country | US
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Telephone | 931-548-3062
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Fax | 615-628-1428
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Provider Business Mailing Address
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Address Line | 8 CADILLAC DR STE 300
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City | BRENTWOOD
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State | TN
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Zip | 37027-5337
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Country | US
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Telephone | 931-548-3062
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Fax | 615-628-1428
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1307
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License Number State | TN
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