Active NPI
Judith Anderson, MA LLP
- Psychologist
- Three Rivers, MI
National Provider Identifier
1205047552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301007833
- Practice address
- 131 Enterprise St
Three Rivers, MI 49093 - Phone
- (269) 273-2024
- NPI assigned
- May 25, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6301007833 | MI | Primary |
Addresses
Primary practice location
131 Enterprise St
Three Rivers, MI 49093
Mailing address
6189 Baywood Dr
Portage, MI 49024-1045
Phone (269) 329-4968
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301007833 | MI | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1205047552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6189 BAYWOOD DR",
"city": "PORTAGE",
"state": "MI",
"postal_code": "490241045",
"telephone_number": "269-329-4968"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "131 ENTERPRISE ST",
"city": "THREE RIVERS",
"state": "MI",
"postal_code": "49093",
"telephone_number": "269-273-2024"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "JUDITH",
"credential": "MA LLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301007833",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Three Rivers, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.