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General NPI Number Information
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NPI Number | 1689685364
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Entity Type | Individual
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Provider Name | SANDRA LYNN ANDERSON MS LPC NCC
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Gender | Female
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 02/10/2020
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Provider Practice Location Address
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Address Line | 1250 E BUSINESS HIGHWAY 151 STE A-3
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City | PLATTEVILLE
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State | WI
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Zip | 53818-3875
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Country | US
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Telephone | 608-348-7474
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Fax | 608-348-7117
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Provider Business Mailing Address
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Address Line | 1250 E BUSINESS HIGHWAY 151 STE A-3
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City | PLATTEVILLE
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State | WI
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Zip | 53818-3875
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Country | US
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Telephone | 608-348-7474
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Fax | 608-348-7117
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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 | 180002900
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License Number State | IL
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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 | 2994125
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License Number State | WI
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