Provider Demographics
NPI:1982261699
Name:ANDERSON COUNSEL WORKS, INC.
Entity Type:Organization
Organization Name:ANDERSON COUNSEL WORKS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:CALLUM
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:954-595-7372
Mailing Address - Street 1:3096 S OAKLAND FOREST DR APT 1606
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33309-5647
Mailing Address - Country:US
Mailing Address - Phone:561-651-9629
Mailing Address - Fax:
Practice Address - Street 1:1881 NE 26TH ST STE 70
Practice Address - Street 2:
Practice Address - City:WILTON MANORS
Practice Address - State:FL
Practice Address - Zip Code:33305-1425
Practice Address - Country:US
Practice Address - Phone:754-212-8951
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-29
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health