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Individual
TERRY ANDERSON
Active
Individual
TERRY ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, MSW, DMIN, LCSW
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
101YP1600X
Pastoral Counselor
—
—
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
34003367A
IN
106H00000X
Marriage & Family Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34003367A
STATE LICENSE
IN
Enumeration date
06/18/2007
Last updated
11/15/2007
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