Provider Demographics
NPI:1285213769
Name:BLUE ANCHOR WELLNESS, LLC
Entity Type:Organization
Organization Name:BLUE ANCHOR WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CARYN
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDREWS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:847-650-9617
Mailing Address - Street 1:72 JEFFERSON LN
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:IL
Mailing Address - Zip Code:60013-1887
Mailing Address - Country:US
Mailing Address - Phone:847-650-9617
Mailing Address - Fax:
Practice Address - Street 1:715 E GOLF RD STE 200A1
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4595
Practice Address - Country:US
Practice Address - Phone:847-650-9617
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-03
Last Update Date:2021-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty