Provider Demographics
NPI:1699420042
Name:VEGGIAN, ANTHONY FRANK (LLMSW)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:FRANK
Last Name:VEGGIAN
Suffix:
Gender:
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29750 HARPER AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48082-2607
Mailing Address - Country:US
Mailing Address - Phone:586-777-3200
Mailing Address - Fax:586-777-7855
Practice Address - Street 1:29750 HARPER AVE
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48082-2607
Practice Address - Country:US
Practice Address - Phone:586-777-3200
Practice Address - Fax:586-777-7855
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-15
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68511140371041C0700X
MI68011193371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty