Individual
MR. JOHN R. ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
3118 S LAFOUNTAIN ST, KOKOMO, IN 46902-3710
(765) 864-4160
(765) 400-4467
Mailing address
8003 CASTLEWAY DR, INDIANAPOLIS, IN 46250-1946
(317) 576-1335
(317) 343-6562
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39001917A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200447850A
—
IN
Enumeration date
03/20/2007
Last updated
02/23/2026
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