Provider Demographics
NPI:1881853166
Name:ANDERSON, LOUIS (LPC)
Entity type:Individual
Prefix:
First Name:LOUIS
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6301 E 41ST ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-6103
Mailing Address - Country:US
Mailing Address - Phone:918-289-0550
Mailing Address - Fax:918-289-0551
Practice Address - Street 1:6301 E 41ST ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-6103
Practice Address - Country:US
Practice Address - Phone:918-289-0550
Practice Address - Fax:918-289-0551
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2927101YA0400X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)