Provider Demographics
NPI:1134485204
Name:ANDERSON COUNSELING CENTER
Entity Type:Organization
Organization Name:ANDERSON COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHAREE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-697-3377
Mailing Address - Street 1:907 HILLCREST PKWY
Mailing Address - Street 2:SUITE E
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31021-4215
Mailing Address - Country:US
Mailing Address - Phone:478-304-1328
Mailing Address - Fax:949-607-5990
Practice Address - Street 1:907 HILLCREST PKWY
Practice Address - Street 2:SUITE E
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-4215
Practice Address - Country:US
Practice Address - Phone:478-304-1328
Practice Address - Fax:949-607-5990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-03
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health