Provider Demographics
NPI:1316702574
Name:WARNER, ANTHONY (RCSWI)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:WARNER
Suffix:
Gender:M
Credentials:RCSWI
Other - Prefix:
Other - First Name:ANTHONY
Other - Middle Name:
Other - Last Name:WARNER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:253 TAMIAMI TRL S
Mailing Address - Street 2:
Mailing Address - City:NOKOMIS
Mailing Address - State:FL
Mailing Address - Zip Code:34275-3136
Mailing Address - Country:US
Mailing Address - Phone:800-430-6062
Mailing Address - Fax:
Practice Address - Street 1:253 TAMIAMI TRL S
Practice Address - Street 2:
Practice Address - City:NOKOMIS
Practice Address - State:FL
Practice Address - Zip Code:34275-3136
Practice Address - Country:US
Practice Address - Phone:800-430-6062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-16
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW18882Q101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor