Provider Demographics
NPI:1285413476
Name:ANDERSON, GEORGE THOMAS (MSW, LCSWA, MBA)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:THOMAS
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:MSW, LCSWA, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1824
Mailing Address - Street 2:
Mailing Address - City:ENKA
Mailing Address - State:NC
Mailing Address - Zip Code:28728-1824
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9 ASBURY ROAD
Practice Address - Street 2:
Practice Address - City:CANDLER
Practice Address - State:NC
Practice Address - Zip Code:28715
Practice Address - Country:US
Practice Address - Phone:828-575-8119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-26
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0197401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical