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General NPI Number Information
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NPI Number | 1629859921
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Entity Type | Individual
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Provider Name | MARIEL FRANCES ANDERSEN
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Gender | Female
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Dates
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Enumeration Date | 10/12/2023
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Last Update Date | 05/23/2024
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Provider Practice Location Address
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Address Line | 2300 COMMONWEALTH DR STE 100
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22901-1894
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Country | US
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Telephone | 855-284-7483
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Fax | 617-807-0958
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Provider Business Mailing Address
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Address Line | PO BOX 748465
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City | ATLANTA
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State | GA
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Zip | 30374-8465
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Country | US
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Telephone | 855-284-7483
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Fax | 617-807-0958
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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 |
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License Number State | VA
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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 | 0904016835
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License Number State | VA
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