MEDICARE: CAMRYN ANDERSON LCMHC ASSOCIATE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	A22170	NC

General Provider Information

NPI Number	:	1720939143
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAMRYN ANDERSON LCMHC ASSOCIATE

Provider Business Mailing Address
First Line	:	4819 EMPEROR BLVD STE 400
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27703-5420
Country	:	US
Telephone Number	:	910-313-4501
Fax Number	:	866-929-0163

Provider Business Practice Location Address
First Line	:	4819 EMPEROR BLVD STE 400
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27703-5420
Country	:	US
Telephone Number	:	919-313-4501
Fax Number	:	866-929-0163

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/04/2026
Last Update Date	:	02/04/2026

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