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General NPI Number Information
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NPI Number | 1770574501
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Entity Type | Individual
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Provider Name | CAROL ANNETTE ANDERSON LCSW
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Gender | Female
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Dates
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Enumeration Date | 11/01/2005
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Last Update Date | 09/13/2021
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Provider Practice Location Address
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Address Line | 3400 N CENTRAL EXPY STE 110-270
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City | RICHARDSON
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State | TX
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Zip | 75080-0039
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Country | US
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Telephone | 972-814-0164
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Fax |
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Provider Business Mailing Address
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Address Line | 3400 N CENTRAL EXPY STE 110-270
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City | RICHARDSON
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State | TX
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Zip | 75080-0039
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Country | US
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Telephone | 972-814-0164
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 9075
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License Number State | TX
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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 | 01631
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License Number State | TX
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