Healthcare Provider Details

I. General information

NPI: 1356518344
Provider Name (Legal Business Name): TOBY ANDERSON LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2008
Last Update Date: 05/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6962 FOREST HILL AVE
RICHMOND VA
23225-1606
US

IV. Provider business mailing address

6962 FOREST HILL AVE
RICHMOND VA
23225-1606
US

V. Phone/Fax

Practice location:
  • Phone: 804-381-9449
  • Fax: 804-320-8738
Mailing address:
  • Phone: 804-381-9449
  • Fax: 804-320-8738

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0904001932
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number0904001932
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: