Provider Demographics
NPI:1225867336
Name:LANTON, ANDRE JR
Entity type:Individual
Prefix:
First Name:ANDRE
Middle Name:
Last Name:LANTON
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:AJ
Other - Middle Name:
Other - Last Name:LANTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:114 STRATFORD PL
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-8539
Mailing Address - Country:US
Mailing Address - Phone:704-880-9150
Mailing Address - Fax:
Practice Address - Street 1:9541 JULIAN CLARK AVE
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-3484
Practice Address - Country:US
Practice Address - Phone:980-297-8237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist