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NPI Code Detail

MEDICARE: MS. SARAH TERESA ANDERSON MA, LPC

MEDICARE: MS. SARAH TERESA ANDERSON MA, 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
1101YP2500XProfessional CounselorLPC009682GA

General Provider Information

NPI Number : 1508389438
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SARAH TERESA ANDERSON MA, LPC
Provider Business Mailing Address
First Line : 101 E MEMORIAL DR
Second Line :
City : HINESVILLE
State : GA
Zip : 31313-2727
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 101 E MEMORIAL DR
Second Line :
City : HINESVILLE
State : GA
Zip : 31313-2727
Country : US
Telephone Number : 912-876-4010
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2017
Last Update Date : 07/23/2017

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