Provider Demographics
NPI:1801804471
Name:SCHEFSTAD, ANTHONY JOSEPH (PHD, LCSW)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:JOSEPH
Last Name:SCHEFSTAD
Suffix:
Gender:M
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 S SWOOPE AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-5704
Mailing Address - Country:US
Mailing Address - Phone:407-462-6210
Mailing Address - Fax:407-644-8035
Practice Address - Street 1:225 S SWOOPE AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-5704
Practice Address - Country:US
Practice Address - Phone:407-462-6210
Practice Address - Fax:407-644-8035
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW4780101YA0400X, 101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSW4780OtherLICENSE NUMBER