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Mr. Anthony Jerome Blalock JR., BSQMHP
Counselor in Petersburg, Virginia
NPI 1184132151

Anthony Jerome Blalock JR. is a Counselor based in Petersburg, VA. Anthony Jerome Blalock JR. practices in Petersburg, VA and has the professional credentials of BSQMHP. The NPI Number for Anthony Jerome Blalock JR. is 1184132151 and holds a License No. (Virginia).

The current practice location address for Anthony Jerome Blalock JR. is 210 Lily Way Apt 3B, Petersburg, VA and can be reached out via phone at 757-770-8214. You can also correspond with Anthony Jerome Blalock JR. through the mailing address at 210 LILY WAY APT 3B, PETERSBURG, VA - 23805-9161 (mailing address contact number: 757-770-8214).

Location: 210 Lily Way Apt 3B, Petersburg, VA, 23805-9161
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1184132151
Provider Name
Anthony Jerome Blalock JR.
Credential
BSQMHP
Provider Entity Type
Individual
Gender
Male
Address
210 Lily Way Apt 3B, Petersburg, VA, 23805-9161
Phone Number
757-770-8214
Fax Number
Provider Enumeration Date
01/12/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
210 Lily Way Apt 3B
City
Petersburg
State
Virginia
Zip
23805-9161
Phone Number
757-770-8214
Fax Number
person
Provider Business Mailing Address Details
Address
210 Lily Way Apt 3B
City
Petersburg
State
Virginia
Zip
23805-9161
Phone Number
757-770-8214
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
()
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
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