Individual
MRS. TERESA M ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC, CADC
Contact information
Practice address
1728 CENTRAL AVE STE 14, FORT DODGE, IA 50501-4200
(515) 955-1836
(515) 955-7115
Mailing address
1728 CENTRAL AVE STE 14, FORT DODGE, IA 50501-4200
(515) 955-1836
(515) 955-7115
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
07061
IA
101YM0800X
Mental Health Counselor
Primary
001287
IA
101YM0800X
Mental Health Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0159608
—
IA
01
—
07466
WELLMARK BC/BS
IA
Enumeration date
07/20/2009
Last updated
10/09/2023
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