Provider Demographics
NPI:1508210006
Name:ANDERSEN-PITCHER, MISTY (LPC)
Entity Type:Individual
Prefix:
First Name:MISTY
Middle Name:
Last Name:ANDERSEN-PITCHER
Suffix:
Gender:F
Credentials: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 N 19TH AVE STE 212
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-5160
Mailing Address - Country:US
Mailing Address - Phone:480-269-5666
Mailing Address - Fax:
Practice Address - Street 1:7219 N 23RD LN
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-7651
Practice Address - Country:US
Practice Address - Phone:480-269-5666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-20
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-18396101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health