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General NPI Number Information
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NPI Number | 1295477594
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Entity Type | Organization
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Legal Business Name | ANDERSON CONSULTING AND COUNSELING SERVICES
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Dates
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Enumeration Date | 04/08/2022
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Last Update Date | 04/20/2022
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Provider Practice Location Address
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Address Line | 1244 HIGHWAY 138 SW STE 92
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City | RIVERDALE
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State | GA
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Zip | 30296-1402
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Country | US
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Telephone | 470-269-0475
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Fax |
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Provider Business Mailing Address
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Address Line | 1244 HIGHWAY 138 SW STE 92
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City | RIVERDALE
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State | GA
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Zip | 30296-1402
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CONSULTANT
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Name | SHELLBY WASHINGTON
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Credential |
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Telephone | 678-383-0907
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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 |
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License Number State |
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