MEDICARE: MR. ANTHONY FRANCIS WERTH JR. MS

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	101YP2500X	Professional Counselor	2700-125	WI
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	12125	WI
3	101YP2500X	Professional Counselor	2700125	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932205358
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ANTHONY FRANCIS WERTH JR. MS

Provider Business Mailing Address
First Line	:	101 FALLS RD STE 326
Second Line	:
City	:	GRAFTON
State	:	WI
Zip	:	53024-2612
Country	:	US
Telephone Number	:	262-421-8980
Fax Number	:	262-421-8971

Provider Business Practice Location Address
First Line	:	101 FALLS RD STE 326
Second Line	:
City	:	GRAFTON
State	:	WI
Zip	:	53024-2612
Country	:	US
Telephone Number	:	262-421-8980
Fax Number	:	262-421-8971

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

Provider Enumeration Date	:	09/15/2006
Last Update Date	:	09/06/2023

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