Provider Demographics
NPI:1548153208
Name:ANDERSON, ALYSHIA NEKOLE (DHS, LADAC)
Entity type:Individual
Prefix:DR
First Name:ALYSHIA
Middle Name:NEKOLE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:DHS, LADAC
Other - Prefix:DR
Other - First Name:ALYSHIA
Other - Middle Name:NEKOLE
Other - Last Name:BONDS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DHS, LADAC
Mailing Address - Street 1:251 NORTHWOOD TER
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37042-5901
Mailing Address - Country:US
Mailing Address - Phone:870-317-3003
Mailing Address - Fax:
Practice Address - Street 1:93 BEAUMONT ST
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-3217
Practice Address - Country:US
Practice Address - Phone:931-274-7588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1250101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)