IndividualActive
Anthony Greenidge, AZ LISAC - 15204
NPI 1518102151 · Addiction (Substance Use Disorder) Counselor · Goodyear, AZ
Provider details
- NPI number
- 1518102151
- Entity type
- Individual
- Primary specialty
- Addiction (Substance Use Disorder) CounselorBehavioral Health & Social Service Providers
- Credential
- AZ LISAC - 15204
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Behavioral Health & Social Service Providers
- Counselor101Y00000X
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
Practice location
17446 W Papago St
Goodyear, AZ 85338-1903
Phone: (919) 827-6628
Approximate (ZIP-level) locationGet directions
Mailing address
17446 W Papago St
Goodyear, AZ 85338-1903
Registry dates
- Enumerated
- 2008-12-11
- Last updated
- 2021-09-30
- Certified
- 2021-09-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.