Healthcare Provider Details

I. General information

NPI: 1780961581
Provider Name (Legal Business Name): NANCY ANDERSON INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2011
Last Update Date: 09/26/2026
Certification Date: 09/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

236 N WASHINGTON ST 5E
MONUMENT CO
80132-8289
US

IV. Provider business mailing address

18950 WING TIP RD
COLORADO SPRINGS CO
80908-2374
US

V. Phone/Fax

Practice location:
  • Phone: 719-330-6614
  • Fax: 719-623-0488
Mailing address:
  • Phone: 719-488-1680
  • Fax: 719-488-1690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6290
License Number StateCO

VIII. Authorized Official

Name: NANCY ANDERSON
Title or Position: PRESIDENT
Credential: M.A., L.P.C.
Phone: 719-330-6614