Provider Demographics
NPI:1043109002
Name:ANCHOR AND BLOOM THERAPY
Entity type:Organization
Organization Name:ANCHOR AND BLOOM THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:734-646-1864
Mailing Address - Street 1:529 BENNINGTON CT
Mailing Address - Street 2:
Mailing Address - City:SALINE
Mailing Address - State:MI
Mailing Address - Zip Code:48176-1071
Mailing Address - Country:US
Mailing Address - Phone:734-646-1864
Mailing Address - Fax:
Practice Address - Street 1:529 BENNINGTON CT
Practice Address - Street 2:
Practice Address - City:SALINE
Practice Address - State:MI
Practice Address - Zip Code:48176-1071
Practice Address - Country:US
Practice Address - Phone:734-646-1864
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)