Provider Demographics
NPI:1477001337
Name:ANDERSON, ABIGAIL KATHRYN (LSW, CSW-INTERN)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:KATHRYN
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:LSW, CSW-INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3982 SALISBURY PL
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-4833
Mailing Address - Country:US
Mailing Address - Phone:702-858-2381
Mailing Address - Fax:
Practice Address - Street 1:3982 SALISBURY PL
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121
Practice Address - Country:US
Practice Address - Phone:702-858-2381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-20
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical