Provider Demographics
NPI:1144658535
Name:ANDERSON COUNSELING AND EDUCATION
Entity type:Organization
Organization Name:ANDERSON COUNSELING AND EDUCATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JERLINDA
Authorized Official - Middle Name:JOYCE
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:314-494-9104
Mailing Address - Street 1:2012 HIGHWAY 160 W
Mailing Address - Street 2:SUITE 16
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708-8401
Mailing Address - Country:US
Mailing Address - Phone:314-494-9104
Mailing Address - Fax:980-355-0769
Practice Address - Street 1:2012 HIGHWAY 160 W
Practice Address - Street 2:SUITE 16
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29708-8401
Practice Address - Country:US
Practice Address - Phone:314-494-9104
Practice Address - Fax:980-355-0769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-22
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5635252Y00000X, 251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No252Y00000XAgenciesEarly Intervention Provider Agency