Provider Demographics
NPI:1902952294
Name:CEDENO, ANTHONY GEORGE SR (LICSW)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:GEORGE
Last Name:CEDENO
Suffix:SR
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-3778
Mailing Address - Country:US
Mailing Address - Phone:508-790-1815
Mailing Address - Fax:508-790-1815
Practice Address - Street 1:218 W MAIN ST
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-3778
Practice Address - Country:US
Practice Address - Phone:508-790-1815
Practice Address - Fax:508-790-1815
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10309721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical