Provider Demographics
NPI:1083667240
Name:ANDERSON, JAMES T (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:T
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2272
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28793-2272
Mailing Address - Country:US
Mailing Address - Phone:828-692-7300
Mailing Address - Fax:828-692-7710
Practice Address - Street 1:45 N COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:BREVARD
Practice Address - State:NC
Practice Address - Zip Code:28712-8908
Practice Address - Country:US
Practice Address - Phone:828-883-9676
Practice Address - Fax:828-884-9753
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0013281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6002848Medicaid
NC2865317DMedicare UPIN
NC6002848Medicaid