Anderson, Terry
Anderson, Terry is an individual health care provider with primary practice located at 300 W Wayne St , Fort Wayne IN 46802-3608. He recently has 6 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Pastoral, Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Counselor is his primary health care specialty. Anderson, Terry can be contacted via phone (260) 422-8556.Contact Information
Primary practice address
300 W Wayne St
Fort Wayne IN 46802-3608
Phone: (260) 422-8556
Fax: (260) 422-8558
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Counselor | 101Y00000X | ||
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | ||
| Behavioral Health & Social Service Providers / Pastoral | 101YP1600X | ||
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | ||
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 34003367A | Indiana |
| Behavioral Health & Social Service Providers / Marriage & Family Therapist | 106H00000X |
Profile Details
| NPI number | 1538364740 |
|---|---|
| LBN Legal business name | Anderson, Terry |
| Credentials | MA, MSW, DMIN, LCSW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 18th, 2007 |
| Last updated | Nov 15th, 2007 - about 17 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 | 1538364740 | NPPES |
| Indiana | Other | 34003367A | STATE LICENSE |
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