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General NPI Number Information
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NPI Number | 1023435807
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Entity Type | Individual
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Provider Name | JEROME ANDERSON DSW, LCSW, BCD, CCFC
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Gender | Male
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Dates
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Enumeration Date | 03/18/2014
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | WALTER REED NATIONAL MEDICAL CENTER 8901 WISCONSIN AVENUE
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City | BETHESDA
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State | MD
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Zip | 20889
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Country | US
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Telephone | 202-699-1860
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Fax |
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Provider Business Mailing Address
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Address Line | 22505 GATEWAY CENTER DR PO BOX 1001
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City | CLARKSBURG
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State | MD
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Zip | 20871-1001
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Country | US
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Telephone | 314-651-4014
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2011009028
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LC200001949
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License Number State | DC
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