Carol Lynn Anderson, ACSW, LMSW, CAAC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801065696 Issued in MI

Practice address

940 E 8TH St
Traverse City, MI 49686-2893

Phone

(231) 922-4810

Fax

(231) 922-4884

NPI assigned

Jan 15, 2010

Last updated

Jan 15, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Old Town Psychological Services

  • Clinical Psychologist
  • Traverse City, MI
  • NPI 1093989162
  NPD (past)
• Old Town Psychological Services-Gaylord

  • Clinical Child & Adolescent Psychologist
  • Gaylord, MI
  • NPI 1750659249
  NPD (past)

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

{
    "created_epoch": "1263513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263513600000",
    "number": "1750612776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 E 8TH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496862893",
            "telephone_number": "231-922-4810",
            "fax_number": "231-922-4884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 E 8TH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496862893",
            "telephone_number": "231-922-4810",
            "fax_number": "231-922-4884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "CAROL",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "ACSW, LMSW, CAAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-15",
        "last_updated": "2010-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801065696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sally Ann Ancel, D.O.
• Anchor and Hope Counseling LLC
• Carl B Anders, MD
• Amy Nicole Anderson, P.T.
• Andrea Anderson
• Carter Burson Anderson, MD
• Marvin Anderson
• Meghan Anderson, R.N.
• Michael Robert Anderson, PHARMD
• Natalie Clare Anderson

• Clinical Social Worker in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2010; 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.