Provider Demographics
NPI:1598843591
Name:DONALD ANDERSON
Entity Type:Organization
Organization Name:DONALD ANDERSON
Other - Org Name:COUNSELING AND CAREER SERVICES OF BRIARWOOD ASSOCIATES
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:540-797-0569
Mailing Address - Street 1:3959 ELECTRIC RD STE 156
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-4571
Mailing Address - Country:US
Mailing Address - Phone:540-772-3119
Mailing Address - Fax:540-387-1047
Practice Address - Street 1:3959 ELECTRIC RD STE 156
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-4571
Practice Address - Country:US
Practice Address - Phone:540-772-3119
Practice Address - Fax:540-387-1047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0717000655101YM0800X
VA0701000664101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty