Provider Demographics
NPI:1316965122
Name:ANDERSON, WALTER PATTERSON JR (LPC, LMFT)
Entity type:Individual
Prefix:MR
First Name:WALTER
Middle Name:PATTERSON
Last Name:ANDERSON
Suffix:JR
Gender:M
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2027 WOODBROOK CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-1148
Mailing Address - Country:US
Mailing Address - Phone:434-975-3636
Mailing Address - Fax:434-975-3636
Practice Address - Street 1:2027 WOODBROOK CT
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-1148
Practice Address - Country:US
Practice Address - Phone:434-975-3636
Practice Address - Fax:434-975-3636
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002658101YP2500X
VA0717000656106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2076072OtherCIGNA
VA454266OtherANTHEM
VA7488392OtherAETNA
VA082775OtherSENTARA