Provider Demographics
NPI:1063309235
Name:ANDERSON, ANDREA ESTHER (MSW, SWLC)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:ESTHER
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MSW, SWLC
Other - Prefix:
Other - First Name:ANDE
Other - Middle Name:
Other - Last Name:MCCOLLUM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 7003
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59771-7003
Mailing Address - Country:US
Mailing Address - Phone:406-219-1350
Mailing Address - Fax:
Practice Address - Street 1:145 MILL TOWN LOOP STE B
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-5144
Practice Address - Country:US
Practice Address - Phone:406-219-1350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-20
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT802981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical