Provider Demographics
NPI:1982839536
Name:A L ANDERSON PSYCHOLOGICAL SERVICES LLC
Entity Type:Organization
Organization Name:A L ANDERSON PSYCHOLOGICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:L
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:330-620-8535
Mailing Address - Street 1:3900 DARROW RD UNIT 2704
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-7345
Mailing Address - Country:US
Mailing Address - Phone:330-620-8535
Mailing Address - Fax:234-380-5930
Practice Address - Street 1:209 S MAIN ST FL 8
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44308-1320
Practice Address - Country:US
Practice Address - Phone:330-620-8535
Practice Address - Fax:234-380-5930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-27
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6528103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty