Stewart Lee Anderson, LPC
Individual provider Active NPI Mental Health Counselor · Lunenburg, VA
NPI 1902129174 · NPPES record last updated Mar 2, 2010
Key facts
- NPI
- 1902129174
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 0701004784 (VA)
- Practice address
- 11387 Courthouse Road
Lunenburg, VA 23952-0040 - Phone
- (434) 696-1623
- Fax
- (434) 696-1753
- NPI assigned
- Mar 2, 2010
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0701004784 | VA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crossroads Services Board | Mental Health | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 0701004784 | VA | Yes |
Addresses
Primary practice location
11387 Courthouse Road
Lunenburg, VA 23952-0040
Mailing address
60 Bush River Drive
Farmville, VA 23901-0248
Phone (434) 696-1623
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528091063 | Medicaid | VA |
Other providers in Lunenburg, VA
All providers in Lunenburg, VA · Mental Health Counselor in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 2, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.