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General NPI Number Information
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NPI Number | 1801321419
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Entity Type | Organization
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Legal Business Name | ANDERSON FAMILY THERAPY
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Dates
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Enumeration Date | 04/21/2017
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Last Update Date | 04/10/2025
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Provider Practice Location Address
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Address Line | 900 CUMMINGS CTR SUITE 410-U
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City | BEVERLY
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State | MA
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Zip | 01915-6198
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Country | US
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Telephone | 978-879-6476
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Fax |
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Provider Business Mailing Address
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Address Line | 900 CUMMINGS CTR SUITE 410-U
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City | BEVERLY
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State | MA
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Zip | 01915-6198
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Country | US
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Telephone | 978-879-6476
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | PETER HOLT ANDERSON
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Credential | LMFT
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Telephone | 978-380-3497
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 1482
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License Number State | MA
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