Provider Demographics
NPI:1245385673
Name:ANDERSON, CAROL A (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:A
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8483 N MILLBROOK AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2153
Mailing Address - Country:US
Mailing Address - Phone:559-323-7263
Mailing Address - Fax:559-431-1550
Practice Address - Street 1:8483 N MILLBROOK AVE STE 101
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2153
Practice Address - Country:US
Practice Address - Phone:559-323-7263
Practice Address - Fax:559-431-1550
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT 29432101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health