Provider Demographics
NPI:1962932624
Name:REDA, ANTHONY JAMES (MA, LAMFT)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:JAMES
Last Name:REDA
Suffix:
Gender:M
Credentials:MA, LAMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11201 N EL MIRAGE RD SPC 44
Mailing Address - Street 2:
Mailing Address - City:EL MIRAGE
Mailing Address - State:AZ
Mailing Address - Zip Code:85335-3104
Mailing Address - Country:US
Mailing Address - Phone:253-740-7241
Mailing Address - Fax:
Practice Address - Street 1:18789 N REEMS RD STE 260B
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-8648
Practice Address - Country:US
Practice Address - Phone:602-620-2874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-15
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAMFT-08055T106H00000X
175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist