MEDICARE: SANDRA ANDERSON

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	1041C0700X	Clinical Social Worker	LCSW-20319	AZ
2	1041C0700X	Clinical Social Worker	LC50079827	DC
3	1041C0700X	Clinical Social Worker	106711	TX
4	1041C0700X	Clinical Social Worker	0904018653	VA
5	1041S0200X	School Social Worker	LC50079827	DC
6	1041C0700X	Clinical Social Worker	21660	MD

General Provider Information

NPI Number	:	1952787814
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA ANDERSON

Provider Business Mailing Address
First Line	:	1200 FIRST STREET NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20002
Country	:	US
Telephone Number	:	240-786-2329
Fax Number	:

Provider Business Practice Location Address
First Line	:	5410 LYNX LN STE 285
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21044-2483
Country	:	US
Telephone Number	:	240-786-2329
Fax Number	:

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

Provider Enumeration Date	:	08/03/2015
Last Update Date	:	08/13/2025

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Directions to “ SANDRA ANDERSON ” Practice Location

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