Healthcare Provider Details

I. General information

NPI: 1326076340
Provider Name (Legal Business Name): CHERI G ANDERSON LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHERI L DAVIS LMSW

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 09/12/2024
Certification Date: 09/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 S PENNSYLVANIA AVE STE 100
LANSING MI
48910-4795
US

IV. Provider business mailing address

PO BOX 10
MASON MI
48854-0010
US

V. Phone/Fax

Practice location:
  • Phone: 517-798-4944
  • Fax:
Mailing address:
  • Phone: 517-676-9788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6801077321
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: