Healthcare Provider Details

I. General information

NPI: 1154713485
Provider Name (Legal Business Name): KATHRYN MICHELLE ANDERS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATHRYN MICHELLE HARDY LSW

II. Dates (important events)

Enumeration Date: 02/24/2015
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 CAROUSEL FARM DR
CENTRE HALL PA
16828-9236
US

IV. Provider business mailing address

119 S BURROWES ST STE 707
STATE COLLEGE PA
16801-3864
US

V. Phone/Fax

Practice location:
  • Phone: 814-699-9114
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW020646
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW131549
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: