Most Relevant Information
Provider Data
| NPI Number: | 1003173253 |
| Provider Name: | KEVIN R ANDERSON LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 34000491A |
Most Important Dates
| Enumeration Date: | 04/12/2012 |
| Last Updated: | 01/09/2017 |
Provider Practice Location
2210 JACKSON ST
ANDERSON
IN
460164363
Practice Location Phone/Fax
| Phone: | 7656833118 |
| Fax: |
Provider Mailing Location
10330 N MERIDIAN ST # 300
INDIANAPOLIS
IN
462901024
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |