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General NPI Number Information
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NPI Number | 1942167556
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Entity Type | Individual
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Provider Name | KYRSTAN ANDERSON LPC-MHSP
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Gender | Female
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Dates
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Enumeration Date | 01/06/2026
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 6401 POPLAR AVE STE 500
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City | MEMPHIS
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State | TN
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Zip | 38119-4808
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Country | US
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Telephone | 901-422-8191
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Fax | 901-746-9331
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Provider Business Mailing Address
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Address Line | PO BOX 497
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City | AUGUSTA
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State | AR
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Zip | 72006-0497
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Country | US
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Telephone | 870-347-2534
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Fax | 870-301-2092
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 2621
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License Number State | TN
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