| Doctor Name: | MICHAEL G ANDERSON |
| NPI Number: | 1215362256 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MSW, LGSW |
| License Number: | BP00944286 |
| Business Practice Address: | 1 Stevens Rd Summersville, WV - 266519704 |
| Business Phone Number: | 3048722659 |
| Business Fax Number: | 3048721685 |
| Mailing Address: | 1305 Webster Rd, SUMMERSVILLE |
| State: | WV |
| Postal Code: | 266511125 |
| Phone Number: | 3048726503 |
| Fax Number: | 3048725415 |
| NPI Enumeration Date: | 09/10/2013 |
| NPI Last Update Date: | 09/10/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | BP00944286 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |