Provider Demographics
NPI:1699651406
Name:ANDERSON, CECELIA MARIE
Entity type:Individual
Prefix:
First Name:CECELIA
Middle Name:MARIE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23313 44TH AVE
Mailing Address - Street 2:
Mailing Address - City:MATTAWAN
Mailing Address - State:MI
Mailing Address - Zip Code:49071-8777
Mailing Address - Country:US
Mailing Address - Phone:269-569-6815
Mailing Address - Fax:269-569-6815
Practice Address - Street 1:4341 S WESTNEDGE AVE STE 1203
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49008-3284
Practice Address - Country:US
Practice Address - Phone:269-569-6815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-15
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical