Provider Demographics
NPI:1033305685
Name:ANDERSON & ASSOCIATES COUNSELING AND PSYCHOLOGIST SERVICES LLC
Entity type:Organization
Organization Name:ANDERSON & ASSOCIATES COUNSELING AND PSYCHOLOGIST SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:M
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:715-539-8080
Mailing Address - Street 1:712 E 2ND ST
Mailing Address - Street 2:PO BOX 551
Mailing Address - City:MERRILL
Mailing Address - State:WI
Mailing Address - Zip Code:54452-2419
Mailing Address - Country:US
Mailing Address - Phone:715-539-8080
Mailing Address - Fax:715-539-8099
Practice Address - Street 1:712 E 2ND ST
Practice Address - Street 2:
Practice Address - City:MERRILL
Practice Address - State:WI
Practice Address - Zip Code:54452-2419
Practice Address - Country:US
Practice Address - Phone:715-539-8080
Practice Address - Fax:715-539-8099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-18
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health