Jacob Anderson, LLC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

6451022424 Issued in MI

Practice address

4439 Butternut St
Clarkston, MI 48348-1312

Phone

(248) 690-5286

NPI assigned

Aug 16, 2021

Last updated

Jan 6, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Henry Ford Health Eastwood Behavioral Health

  dba Eastwood Clinics

  • Social Worker
  • Clinton Township, MI
  • NPI 1396787701
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1629072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1164198693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4439 BUTTERNUT ST",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483481312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4439 BUTTERNUT ST",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483481312",
            "telephone_number": "248-690-5286"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7640 Dixie Hwy",
            "address_purpose": "LOCATION",
            "city": "Clarkston",
            "state": "MI",
            "postal_code": "483462082",
            "country_code": "US",
            "telephone_number": "586-322-3499",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "114 Orchard Lake Rd",
            "address_purpose": "LOCATION",
            "city": "Pontiac",
            "state": "MI",
            "postal_code": "483412244",
            "country_code": "US",
            "telephone_number": "248-858-7766 x1250",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "37500 Garfield Rd Ste 175",
            "address_purpose": "LOCATION",
            "city": "Clinton Twp",
            "state": "MI",
            "postal_code": "480363664",
            "country_code": "US",
            "telephone_number": "586-792-5335",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "837 S Lapeer Rd Ste 205",
            "address_purpose": "LOCATION",
            "city": "Oxford",
            "state": "MI",
            "postal_code": "483715084",
            "country_code": "US",
            "telephone_number": "248-572-7002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JACOB",
        "credential": "LLC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-16",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "C.2103322-TRNE",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6451022424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra Aloia
• Noor Alshorji
• Nehal Altaie, MD
• Rene Ayanna Amsterdam
• Rebecca Jo Anastasi, MA
• Julianna Andre
• Lisa Andreski, RN
• Aurora C. Andrews, M.D.
• Taras Andrushkiw, NP-C
• Sara Andrykovich

• Counselor in Clarkston, MI
• Providers in Clarkston, MI by specialty
• Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.