Gary L Anderson, LPC
Individual provider Active NPI Professional Counselor · Delta, UT
NPI 1013123553 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1013123553
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 378274-6004 (UT)
- Practice address
- 252 W Main St
Delta, UT 84624-9256 - Phone
- (435) 864-7072
- NPI assigned
- May 14, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 378274-6004 | UT | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 378274-6004 | UT | Yes |
Addresses
Primary practice location
252 W Main St
Delta, UT 84624-9256
Mailing address
360 N. 525 E.
Delta, UT 84624
Phone (435) 864-7072
Other providers in Delta, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.