Provider Demographics
NPI:1689552085
Name:SMITH, ANTHONY ROBERT (MA)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:ROBERT
Last Name:SMITH
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 ELM ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01952-1803
Mailing Address - Country:US
Mailing Address - Phone:978-912-4298
Mailing Address - Fax:
Practice Address - Street 1:800 W CUMMINGS PARK STE 3400
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-6551
Practice Address - Country:US
Practice Address - Phone:781-726-4149
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-25
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty