Individual
CAROL ANNETTE ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3400 N CENTRAL EXPY, STE 110-270, RICHARDSON, TX 75080-0039
(972) 814-0164
Mailing address
3400 N CENTRAL EXPY, STE 110-270, RICHARDSON, TX 75080-0039
(972) 814-0164
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
9075
TX
1041C0700X
Clinical Social Worker
Primary
01631
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005089457
AETNA PIN
TX
01
—
009398
VALUE OPTIONS
TX
01
—
00S78J
BLUE CROSS BLUE SHIELD
TX
01
—
077171000
MAGELLAN
TX
05
—
1082711-02
—
TX
Enumeration date
11/01/2005
Last updated
09/13/2021
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