Healthcare Provider Details

I. General information

NPI: 1154024917
Provider Name (Legal Business Name): ANDERSON MENTAL HEALTH COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2023
Last Update Date: 03/22/2023
Certification Date: 03/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

237 DELAWARE AVE STE 2
OLEAN NY
14760-2601
US

IV. Provider business mailing address

787 LIPPERT HOLLOW RD
ALLEGANY NY
14706-9715
US

V. Phone/Fax

Practice location:
  • Phone: 716-307-3055
  • Fax:
Mailing address:
  • Phone: 716-307-3055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER CARL ANDERSON
Title or Position: LICENSED MENTAL HEALTH COUNSELOR
Credential: M.S.ED.
Phone: 716-307-3055