MEDICARE: JEFFREY ALLAN ANDERSON LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	18450	TX

General Provider Information

NPI Number	:	1457451908
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY ALLAN ANDERSON LPC

Provider Business Mailing Address
First Line	:	7108 WATER MEADOWS DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76123-2981
Country	:	US
Telephone Number	:	682-472-9200
Fax Number	:	682-472-9200

Provider Business Practice Location Address
First Line	:	2505 N HWY 360
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75050-7818
Country	:	US
Telephone Number	:	682-206-9274
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/24/2006
Last Update Date	:	04/13/2026

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Directions to “ JEFFREY ALLAN ANDERSON LPC” Practice Location

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