DR. JASON A ANDERSEN (NPI# 1740516731) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740516731 |
| Entity Type | Individual |
| Full Name | DR. JASON A ANDERSEN |
| Other Name | DR. ANDY ANDERSEN |
| Credential | PSY.D |
| Practice Address |
120 E Trinity Pl Decatur GA 30030-3302 |
| Practice Telephone | 4046683766 |
| Mailing Telephone | 4046683766 |
| Enumeration Date | 2009-10-26 |
| Last Update Date | 2009-10-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TC0700X |
Psychologist Specialization: Clinical |
3325 | GA | Behavioral Health & Social Service Providers |
| N | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
3325 | GA | Behavioral Health & Social Service Providers |
| Y | 103TF0000X |
Psychologist Specialization: Family |
3325 | GA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992096903 | Jason Scott Andersen | Orthopaedic Surgery | 150 Gentilly Blvd, Cartersville, GA 30120-8522 | 2011-04-25 |
| 1932293727 | Jason L Andersen | Psychiatry & Neurology | 97 S. Professional Way, Payson, UT 84651 | 2006-10-03 |
| 1841229648 | Jason Andersen | Counselor | 1015 S Broadway Ste 18, Minot, ND 58701-4667 | 2006-07-02 |
| Street Address |
120 E TRINITY PL |
| City | DECATUR |
| State | GA |
| Zip Code | 30030-3302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326131442 | Leigh Caroline Gobbel | Social Worker | 120 E Trinity Pl, Decatur, GA 30030 | 2006-10-02 |
| 1124629803 | Brooks Byrd Kolberg | Counselor | 120 E Trinity Pl, Decatur, GA 30030-3302 | 2020-11-08 |
| 1558969576 | Alexis Simone Arnold | Social Worker | 120 E Trinity Pl, Decatur, GA 30030-3302 | 2020-10-12 |
| 1124631916 | Sarah Schulman | Social Worker | 120 E Trinity Pl, Decatur, GA 30030-3302 | 2020-08-31 |
| 1982226692 | Rebecca Peacock | Student in an Organized Health Care Education/Training Program | 120 E Trinity Pl, Decatur, GA 30030-3302 | 2020-05-15 |
| 1700408937 | Mayesha R Bassett | Student in an Organized Health Care Education/Training Program | 120 E Trinity Pl, Decatur, GA 30030-3302 | 2020-05-11 |
| 1457972903 | Bethany Joy Bagley | Counselor | 120 E Trinity Pl, Decatur, GA 30030-3302 | 2020-05-06 |
| 1811517113 | Jabari Eric Scott | Counselor | 120 E Trinity Pl, Decatur, GA 30030-3302 | 2020-04-16 |
| 1497374946 | Janel Robyn Harris | Counselor | 120 E Trinity Pl, Decatur, GA 30030-3302 | 2020-04-15 |
| 1184243339 | Jezreel Amica | Social Worker | 120 E Trinity Pl, Decatur, GA 30030-3302 | 2020-04-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801413174 | Pa-c Surgical Assist, LLC | Clinic/Center | 520 W Ponce Leon Ave #1706, Decatur, GA 30030 | 2020-07-02 |
| 1417587478 | Elizabeth Heffron | Acupuncturist | 619b East College Avenue, Decatur, GA 30030 | 2020-01-17 |
| 1669016143 | Atlanta Upper Cervical Chiropractic LLC | Chiropractor | 125 E Trinity Place, Suite #247, Decatur, GA 30030 | 2019-10-29 |
| 1831757418 | Jessica Stewart | Counselor | 755 Commerce Dr Ste 903, Decatur, GA 30030 | 2019-05-30 |
| 1699238733 | Dinah Augustin | Registered Nurse | 1458 Church St., Unit B, Decatur, GA 30030 | 2019-04-06 |
| 1093284291 | Eliza Segell | Social Worker | 165 Dekalb Industrial Way Ste D-1, Decatur, GA 30030 | 2018-11-16 |
| 1912476466 | Positive Impact Health Centers, Inc. | Pharmacy | 523 Church Street, Suite B, Decatur, GA 30030 | 2018-11-14 |
| 1932685096 | T2 Imaging | Radiology | 1376 Church Street, Suite 100, Decatur, GA 30030 | 2018-07-12 |
| 1992292858 | Keeanna M Powell | Counselor | Agape Transformation Practice, 235 E. Ponce De Leon Ave Suite 103, Decatur, GA 30030 | 2018-04-17 |
| 1780185488 | Solutions Ae Inc | Counselor | One West Square Court, Suite 710, Decatur, GA 30030 | 2018-02-27 |
| Find all providers in zip 30030 | ||||
| Taxonomy Code | 103TF0000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811474125 | Demetrius Roman | Psychologist | 1580 Phoenix Blvd Ste 200, Atlanta, GA 30349-5187 | 2018-07-19 |
| 1184847212 | Gloria Desantis Meaux | Psychologist | 18 Lenox Pointe Ne # B, Atlanta, GA 30324-3168 | 2007-04-10 |
| 1982733713 | Fred D Fraser | Psychologist | 11755 Pointe Pl, Roswell, GA 30076-4636 | 2007-03-05 |
Please comment or provide details below to improve the information on DR. JASON A ANDERSEN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.