Provider Demographics
NPI:1952826943
Name:ANDERSON, ERIC DEAN (PHD, CRC)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:DEAN
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:PHD, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 S 3RD ST STE 210
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-4206
Mailing Address - Country:US
Mailing Address - Phone:614-266-0700
Mailing Address - Fax:614-895-6801
Practice Address - Street 1:20 S 3RD ST STE 210
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-4206
Practice Address - Country:US
Practice Address - Phone:614-266-0700
Practice Address - Fax:614-895-6801
Is Sole Proprietor?:No
Enumeration Date:2017-08-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH7488103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation