| Anthony Miceli, | |
|
121 Downey Ave, Modesto, CA 95354-1208 | |
| (209) 341-1824 | |
| Not Available |
| Full Name | Anthony Miceli |
|---|---|
| Gender | Male |
| Speciality | Marriage & Family Therapist |
| Location | 121 Downey Ave, Modesto, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053637371 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 53523 (California) | Primary |
| Entity Name | Grow Healthcare Group Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154994846 PECOS PAC ID: 1850774746 Enrollment ID: O20220809004080 |
| Mailing Address | Practice Location Address |
|---|---|
| Anthony Miceli, 121 Downey Ave, Modesto, CA 95354-1208 Ph: (209) 341-1824 | Anthony Miceli, 121 Downey Ave, Modesto, CA 95354-1208 Ph: (209) 341-1824 |
Roberta Margaret Elledge, LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 819 15th St, Modesto, CA 95354 Phone: 209-549-9608 Fax: 209-522-5700 | |
Paige A Cole, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 121 Downey Ave, Modesto, CA 95354 Phone: 559-577-6995 | |
Ana Lisette Santos, LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 1400 K St Ste B, Modesto, CA 95354 Phone: 209-550-5869 Fax: 209-523-0442 | |
Mr. Pete Herron, LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 615 13th St, Modesto, CA 95354 Phone: 209-380-3187 Fax: 209-846-0913 | |
Emily Jane Mitchell, LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 500 N 9th St Ste C, Modesto, CA 95350 Phone: 209-552-2720 | |
Mrs. Pamela Christine Remides, MFT TRAINEE Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 615 14th St, Modesto, CA 95354 Phone: 209-524-4858 | |
Elisa Aileen Gonzalez, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 5815 Stoddard Rd Ste 600, Modesto, CA 95356 Phone: 209-348-9786 |