Individual
MR. JUSTIN SHAW ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1810 PLUM ST STE F, VALDOSTA, GA 31601-7583
(229) 241-8995
(229) 241-8997
Mailing address
1810 PLUM ST STE F, VALDOSTA, GA 31601-7583
(229) 241-8995
(229) 241-8997
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW003946
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3012275978A
—
GA
Enumeration date
06/10/2009
Last updated
03/19/2010
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