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MR. JUSTIN SHAW ANDERSON LCSW

Clinical >> Social Worker >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1255567780

Individual Registrant:
MR. JUSTIN SHAW ANDERSON LCSW
Gender: M
Sole Proprietor

Location and contact information for practice:
1810 PLUM ST STE F  VALDOSTA, GA 31601-7583 US
Tel: 229-241-8995  Fax: 229-241-8997

Contact information for business:
1810 PLUM ST STE F  VALDOSTA, GA 31601-7583 US
Tel: 229-241-8995  Fax: 229-241-8997

Registration Information:
NPI: 1255567780
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1041C0700XBehavioral Health & Social Service Providers
Social Worker
Clinical
GACSW003946

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
3012275978AGA05




HEALTH CARE JOBS GA - Page 1



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