Provider Demographics
NPI:1780961581
Name:NANCY ANDERSON INC
Entity type:Organization
Organization Name:NANCY ANDERSON INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:719-330-6614
Mailing Address - Street 1:18950 WING TIP RD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80908-2374
Mailing Address - Country:US
Mailing Address - Phone:719-488-1680
Mailing Address - Fax:719-488-1690
Practice Address - Street 1:236 N WASHINGTON ST
Practice Address - Street 2:5E
Practice Address - City:MONUMENT
Practice Address - State:CO
Practice Address - Zip Code:80132-8289
Practice Address - Country:US
Practice Address - Phone:719-330-6614
Practice Address - Fax:719-623-0488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-08
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6290251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management