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General NPI Number Information
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NPI Number | 1942509823
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Entity Type | Individual
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Provider Name | ELVERA VANESTA ANDERSON LLPC, LBSW
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Gender | Female
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Dates
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Enumeration Date | 03/18/2011
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Last Update Date | 03/18/2011
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Provider Practice Location Address
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Address Line | 12800 E WARREN AVE
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City | DETROIT
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State | MI
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Zip | 48215-2061
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Country | US
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Telephone | 313-824-8000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 241362
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City | DETROIT
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State | MI
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Zip | 48224-5362
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Country | US
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Telephone | 313-824-8000
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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 | 64001009275
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6802073402
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License Number State | MI
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