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General NPI Number Information
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NPI Number | 1407541089
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Entity Type | Individual
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Provider Name | WILLIAM BRANTLEY ANDERSON PHD, JD
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Gender | Male
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Dates
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Enumeration Date | 04/10/2023
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Last Update Date | 04/16/2024
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Provider Practice Location Address
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Address Line | 15 VALLEY DR STE 1
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City | GREENWICH
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State | CT
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Zip | 06831-5205
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Country | US
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Telephone | 203-900-1666
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Fax | 203-635-7365
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Provider Business Mailing Address
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Address Line | 76 NARROWS RD
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City | BEDFORD HILLS
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State | NY
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Zip | 10507-2526
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Country | US
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Telephone | 310-903-8027
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | P127249
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License Number State | NY
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