Provider Demographics
NPI:1144749573
Name:ANDERSON, MICHAEL LLOYD (LPC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:LLOYD
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4127 BROWNSVILLE RD STE 205
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:15227-3348
Mailing Address - Country:US
Mailing Address - Phone:412-405-6089
Mailing Address - Fax:412-219-5959
Practice Address - Street 1:4127 BROWNSVILLE RD STE 205
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:PA
Practice Address - Zip Code:15227-3348
Practice Address - Country:US
Practice Address - Phone:412-405-6089
Practice Address - Fax:412-219-5959
Is Sole Proprietor?:No
Enumeration Date:2017-09-18
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC012043101YP2500X
OHC.1700692101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor