Provider Demographics
NPI:1205161585
Name:ANDERSON, KARI (DBH, LPC)
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:DBH, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8050 S POINTE PKWY W APT 3001
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-5429
Mailing Address - Country:US
Mailing Address - Phone:802-282-1799
Mailing Address - Fax:
Practice Address - Street 1:111 S HEARTHSTONE WAY
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-5010
Practice Address - Country:US
Practice Address - Phone:802-282-1799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-05
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-1674101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional