Active NPI
Jerald Stuart Andersen, LPC, LMFT
- Mental Health Counselor
- Cedar Park, TX
National Provider Identifier
1295901122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 10199
- Practice address
- 900 Quest Pkwy
Cedar Park, TX 78613-2270 - Phone
- (512) 260-6100
- Fax
- (512) 260-6129
- NPI assigned
- Apr 30, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 10199 | TX | Primary |
Addresses
Primary practice location
900 Quest Pkwy
Cedar Park, TX 78613-2270
Mailing address
900 Quest Pkwy
Cedar Park, TX 78613-2270
Phone (512) 260-6100
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10199 | TX | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209513600000",
"number": "1295901122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 QUEST PKWY",
"city": "CEDAR PARK",
"state": "TX",
"postal_code": "786132270",
"telephone_number": "512-260-6100",
"fax_number": "512-260-6129"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 QUEST PKWY",
"city": "CEDAR PARK",
"state": "TX",
"postal_code": "786132270",
"telephone_number": "512-260-6100",
"fax_number": "512-260-6129"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSEN",
"first_name": "JERALD",
"middle_name": "STUART",
"name_prefix": "Mr.",
"credential": "LPC, LMFT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-04-30",
"last_updated": "2008-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "10199",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cedar Park, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.