Individual
GARY THOMAS ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1014 E MARKET ST, CHARLOTTESVILLE, VA 22902-5345
(434) 972-1745
(434) 979-5119
Mailing address
953 INDIAN CREEK RD, AMHERST, VA 24521-5002
(434) 221-2168
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0701011605
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0701011605
LPC LICENSE NUMBER
VA
Enumeration date
10/13/2022
Last updated
10/13/2022
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