JACOB ANDERSON LLC NPI 1164198693

NPI Information

  • NPI: 1164198693
  • Provider Name: JACOB ANDERSON, LLC
  • Classification: Counselor - 101Y00000X
  • Entity Type: Individual
  • Address: 4439 BUTTERNUT ST
    CLARKSTON, MI
    ZIP 48348
  • Phone: (248) 690-5286

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NPI Details

Jacob Anderson, LLC is a counselor in Clarkston, MI. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. Jacob Anderson, LLC NPI is 1164198693. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4439 BUTTERNUT ST
CLARKSTON, MI
ZIP 48348-312
Phone: (248) 690-5286

The enumeration date for this NPI number is 8/16/2021 and was last updated on 1/6/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101Y00000XCounselorC.2103322-TRNEOHIONo
2101Y00000XCounselor6451022424MICHIGANYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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