Provider Demographics
NPI:1821258526
Name:FIERRO, ANTHONY J
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:J
Last Name:FIERRO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30745 RED MAPLE LN
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-5354
Mailing Address - Country:US
Mailing Address - Phone:313-473-0778
Mailing Address - Fax:
Practice Address - Street 1:30745 RED MAPLE LN
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-5354
Practice Address - Country:US
Practice Address - Phone:313-473-0778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011207561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical