Provider Demographics
NPI:1770725350
Name:ANDERSON, JANET LEA (MA, LPC, NCC)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:LEA
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 BEVERLY LN
Mailing Address - Street 2:601 BEVERLY LANE
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-2439
Mailing Address - Country:US
Mailing Address - Phone:512-300-0865
Mailing Address - Fax:
Practice Address - Street 1:1910 S BAGDAD RD
Practice Address - Street 2:
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-2806
Practice Address - Country:US
Practice Address - Phone:512-300-9865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-30
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61834101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional