Provider Demographics
NPI:1427665041
Name:ANDERSON, MATTHEW HARLAN (LPC)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:HARLAN
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:940 S PEORIA ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-3334
Mailing Address - Country:US
Mailing Address - Phone:303-579-9282
Mailing Address - Fax:
Practice Address - Street 1:13111 E BRIARWOOD AVE STE 260
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-3926
Practice Address - Country:US
Practice Address - Phone:303-730-8858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-28
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0017799101YM0800X
COLPC.0018623101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health