Provider Demographics
NPI:1154704369
Name:ANDERSON PSYCHOLOGICAL ASSOCIATES
Entity type:Organization
Organization Name:ANDERSON PSYCHOLOGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANA
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:480-567-9771
Mailing Address - Street 1:7033 E GREENWAY PKWY STE 120
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-2075
Mailing Address - Country:US
Mailing Address - Phone:480-567-9771
Mailing Address - Fax:480-567-9771
Practice Address - Street 1:7047 E GREENWAY PKWY
Practice Address - Street 2:SUITE 250
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-8107
Practice Address - Country:US
Practice Address - Phone:917-428-6209
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-07
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4604103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ176828OtherMEDICARE PTAN