Provider Demographics
NPI:1740736982
Name:ANDERSON, CELESTE (CMHC, CPC)
Entity Type:Individual
Prefix:MRS
First Name:CELESTE
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:CMHC, CPC
Other - Prefix:MS
Other - First Name:CELESTE
Other - Middle Name:
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CMHC, CPC
Mailing Address - Street 1:645 MAYAN CIR STE A
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:NV
Mailing Address - Zip Code:89027-4341
Mailing Address - Country:US
Mailing Address - Phone:702-289-7650
Mailing Address - Fax:
Practice Address - Street 1:1173 S 250 W STE 203
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770
Practice Address - Country:US
Practice Address - Phone:435-668-4138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-28
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8213025-6004101YM0800X
UT8213025-6009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health