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General NPI Number Information
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NPI Number | 1467165530
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Entity Type | Individual
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Provider Name | SHARINA DEADRA ANDERSON LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/03/2023
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Last Update Date | 01/03/2023
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Provider Practice Location Address
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Address Line | 7639 HULL STREET RD STE 101
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23235-6438
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Country | US
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Telephone | 804-745-1402
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Fax | 804-409-1702
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Provider Business Mailing Address
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Address Line | 6221 CENTENARY DR APT C
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City | PORTSMOUTH
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State | VA
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Zip | 23703-2815
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Country | US
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Telephone | 757-338-6858
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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 | 0904014651
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License Number State | VA
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