Jeremy Russell Anderson in Jonesboro - Mental Health
Jeremy Russell Anderson - NPI 1003946369
Jeremy Russell Anderson is a Mental Health in Jonesboro, Arkansas. Jeremy Russell Anderson practices all healthcare services and medical treatments related to Mental Health. The NPI Number for Jeremy Russell Anderson is 1003946369. The last update date is 2016-02-12.
Jeremy Russell Anderson's current location address is 1815 Pleasant Grove Road, Jonesboro, Arkansas. You can contact this provider via phone number 8709336886 and fax number 8709339395. The mailing address for Jeremy Russell Anderson is 1815 Pleasant Grove Road, Jonesboro, Arkansas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jeremy Russell Anderson |
|---|---|
| Address | 1815 Pleasant Grove Road, Jonesboro, Arkansas |
| Phone Number | 8709336886 |
| Fax Number | 8709339395 |
| Sole Proprietor | Y |
| Credentials | LPC |
NPI Number Detail
| NPI Number | 1003946369 |
|---|---|
| Provider Enumeration Date | 2007-03-06 |
| Last Updated Date | 2016-02-12 |
Provider Mailing Address Detail
| Address | 1815 Pleasant Grove Road |
|---|---|
| City | Jonesboro |
| State | Arkansas (AR) |
| Post Code | 724017870 |
| Phone Number | 8709336886 |
| Fax Number | 8709339395 |
Provider's Primary Taxonomy Detail
| Speciality | Mental Health |
|---|---|
| Taxonomy | 101Ym0800X |
| Licence No | P1307080 |
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Definition: A counselor who helps people manage conditions like depression, anxiety, grief, relationship issues, and more. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 5WW07 | AR | BCBS |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Jeremy Russell Anderson by the Centers for Medicare & Medicaid Services?
The Jeremy Russell Anderson has been issued the NPI (National Provider Identifier) 1003946369 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you share the physical location details of Jeremy Russell Anderson?
The Jeremy Russell Anderson is situated at 1815 Pleasant Grove Road, in the city of Jonesboro, state of AR, with the zip code 724017870.
What is Jeremy Russell Anderson's specialized field of practice, and what is the corresponding taxonomy classification code?
The Jeremy Russell Anderson's area of specialization is Mental Health, and the corresponding taxonomy code that categorizes this field of practice is 101Ym0800X.
On what date was the 1003946369 assigned to Jeremy Russell Anderson?
The Jeremy Russell Anderson was issued its 1003946369 on 2007-03-06, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information pertaining to Jeremy Russell Anderson, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Jeremy Russell Anderson, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2016-02-12.
NPI Number: 1407858566
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