Individual provider Active NPI

Andrew Ian Anderson, MA LMHC INTERN

  • Mental Health Counselor
  • Pensacola, FL
National Provider Identifier
1316870678
Registry record updated Jun 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
28359 Issued in FL
Practice address
4400 Bayou Blvd Ste 34
Pensacola, FL 32503-2682
Phone
(850) 760-2300
Fax
(833) 895-1385
NPI assigned
Jun 5, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 28359 FL Primary

Addresses

Primary practice location

4400 Bayou Blvd Ste 34
Pensacola, FL 32503-2682

Mailing address

3148 Border Creek Rd
Crestview, FL 32539-9061

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

LicenseStateTypeSpecialty
28359FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1780617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780617600000",
    "number": "1316870678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3148 BORDER CREEK RD",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325399061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 BAYOU BLVD STE 34",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032682",
            "telephone_number": "850-760-2300",
            "fax_number": "833-895-1385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ANDREW",
        "middle_name": "IAN",
        "name_prefix": "Mr.",
        "credential": "MA LMHC INTERN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-06-05",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "28359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2026; 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.