MEDICARE: ANTHONY MARCUS BEGAY

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	10738	AZ

General Provider Information

NPI Number	:	1669250510
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY MARCUS BEGAY

Provider Business Mailing Address
First Line	:	PO BOX 1967
Second Line	:
City	:	WINDOW ROCK
State	:	AZ
Zip	:	86515-1967
Country	:	US
Telephone Number	:	928-871-7679
Fax Number	:

Provider Business Practice Location Address
First Line	:	48 WEST HIGHWAY 264 QUALITY INN OFFICE COMPLEX
Second Line	:	SUITE 106
City	:	WINDOW ROCK
State	:	AZ
Zip	:	86515-1967
Country	:	US
Telephone Number	:	928-871-7679
Fax Number	:

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

Provider Enumeration Date	:	09/20/2023
Last Update Date	:	09/20/2023

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