Healthcare Provider Details

I. General information

NPI: 1073846291
Provider Name (Legal Business Name): MARSHAY ANDERSON MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2009
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date: 03/31/2015
Reactivation Date: 03/27/2017

III. Provider practice location address

8220 LONGLEAF DR
ELK GROVE CA
95758-1322
US

IV. Provider business mailing address

P.O. BOX 232382
SACRAMENTO CA
95823
US

V. Phone/Fax

Practice location:
  • Phone: --
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLCSW74443
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: