Provider Demographics
NPI:1316000474
Name:ANDERSON, HELMUT JOHN (LCSW-529)
Entity Type:Individual
Prefix:MR
First Name:HELMUT
Middle Name:JOHN
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:LCSW-529
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2706 ANKENY WAY
Mailing Address - Street 2:
Mailing Address - City:ROCK SPRINGS
Mailing Address - State:WY
Mailing Address - Zip Code:82901
Mailing Address - Country:US
Mailing Address - Phone:307-352-6689
Mailing Address - Fax:307-352-6692
Practice Address - Street 1:1124 COLLEGE HILL DR.
Practice Address - Street 2:
Practice Address - City:ROCK SPRINGS
Practice Address - State:WY
Practice Address - Zip Code:82901
Practice Address - Country:US
Practice Address - Phone:307-352-6689
Practice Address - Fax:307-352-6692
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLCSW529101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health