Anderson, Glen Wayne
Anderson, Glen Wayne is an individual health care provider with primary practice located at 1650 Greenfield St , Wilmington NC 28401-6456. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Anderson, Glen Wayne can be contacted via phone (910) 798-3500.Contact Information
Primary practice address
1650 Greenfield St
Wilmington NC 28401-6456
Phone: (910) 798-3500
Fax: (910) 798-7834
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 2159 | North Carolina |
Profile Details
| NPI number | 1346369808 |
|---|---|
| LBN Legal business name | Anderson, Glen Wayne |
| Credentials | M.A., L.P.A. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 28th, 2007 |
| Last updated | Mar 16th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1346369808 | NPPES |
| North Carolina | MEDICAID | 6107247 | |
| North Carolina | Other | 046AE |
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