Sandra Sue Anderson, MED. L.P.C.

Individual provider Active NPI Professional Counselor · Mesa, AZ

NPI 1073676094 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1073676094
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
LPC0552 (AZ)
Practice address
3660 E University Dr Ste 6B
Mesa, AZ 85205-6960
Phone
(480) 540-8477
Fax
(480) 654-9860
NPI assigned
Dec 19, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LPC0552AZMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC0552 AZ Yes

Addresses

Primary practice location

3660 E University Dr Ste 6B
Mesa, AZ 85205-6960

Mailing address

549 E McKellips Rd Lot 19
Mesa, AZ 85203-2552
Phone (480) 644-0443

Other providers in Mesa, AZ

All providers in Mesa, AZ · Professional Counselor in Arizona

Sources for this page

Verify at the official NPI Registry.