Individual
MR. JEREMY RUSSELL ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1815 PLEASANT GROVE ROAD, JONESBORO, AR 72401-7870
(870) 933-6886
(870) 933-9395
Mailing address
1815 PLEASANT GROVE ROAD, JONESBORO, AR 72401-7870
(870) 933-6886
(870) 933-9395
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
P1307080
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5WW07
BCBS
AR
Enumeration date
03/06/2007
Last updated
02/12/2016
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