MEDICARE: KYRSTAN ANDERSON LPC-MHSP

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	101Y00000X	Counselor	2621	TN

General Provider Information

NPI Number	:	1942167556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYRSTAN ANDERSON LPC-MHSP

Provider Business Mailing Address
First Line	:	PO BOX 497
Second Line	:
City	:	AUGUSTA
State	:	AR
Zip	:	72006-0497
Country	:	US
Telephone Number	:	870-347-2534
Fax Number	:	870-301-2092

Provider Business Practice Location Address
First Line	:	6401 POPLAR AVE STE 500
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38119-4808
Country	:	US
Telephone Number	:	901-422-8191
Fax Number	:	901-746-9331

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

Provider Enumeration Date	:	01/06/2026
Last Update Date	:	01/06/2026

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Directions to “ KYRSTAN ANDERSON LPC-MHSP” Practice Location

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