Donald E Andersen, LICSW

Individual provider Active NPI Mental Health Counselor · Longview, WA

NPI 1992031397 · NPPES record last updated Oct 20, 2009

Key facts

NPI
1992031397
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
LW00006845 (WA)
Practice address
921 14TH Ave
Longview, WA 98632-2316
Phone
(360) 577-0266
Fax
(360) 577-0269
NPI assigned
Oct 20, 2009
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LW00006845WAMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LW00006845 WA Yes

Addresses

Primary practice location

921 14TH Ave
Longview, WA 98632-2316

Mailing address

921 14TH Ave
Longview, WA 98632-2316
Phone (360) 577-0266

Other providers in Longview, WA

All providers in Longview, WA · Mental Health Counselor in Washington

Sources for this page

Verify at the official NPI Registry.