Healthcare Provider Details

I. General information

NPI: 1083449003
Provider Name (Legal Business Name): MR. STEVEN ANDERSON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2024
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 PLATT RD
ANN ARBOR MI
48104-5155
US

IV. Provider business mailing address

8390 BARRINGTON DR
YPSILANTI MI
48198-9446
US

V. Phone/Fax

Practice location:
  • Phone: 734-477-9999
  • Fax:
Mailing address:
  • Phone: 810-908-8803
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TP0814X
TaxonomyPsychoanalysis Psychologist
License Number6362010139
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: