Provider Demographics
NPI:1346123262
Name:CROSBY, ANTONIO DEELSTANANDO (LLMSW)
Entity type:Individual
Prefix:
First Name:ANTONIO
Middle Name:DEELSTANANDO
Last Name:CROSBY
Suffix:
Gender:M
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4704 SAINT ANTOINE ST APT 202
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201-1466
Mailing Address - Country:US
Mailing Address - Phone:313-401-4998
Mailing Address - Fax:
Practice Address - Street 1:4704 SAINT ANTOINE ST APT 202
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-1466
Practice Address - Country:US
Practice Address - Phone:313-401-4998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)