Kay Kelly Anderson, MED
Individual provider Active NPI Marriage & Family Therapist · Winchester, ID
NPI 1013135946 · NPPES record last updated Jun 8, 2020
Key facts
- NPI
- 1013135946
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- LMFT2977 (ID)
- Practice address
- 1995 Winchester Road
Winchester, ID 83555 - Phone
- (208) 791-8544
- Fax
- (208) 743-5358
- NPI assigned
- Apr 24, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCPC2976 | ID | MD | Mental Health Counselor |
| LMFT2977 | ID | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anderson Gallaher & Associates | Marriage & Family Therapist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LCPC2976 | ID | |
| Marriage & Family Therapist | 106H00000X | LMFT2977 | ID | Yes |
Addresses
Primary practice location
1995 Winchester Road
Winchester, ID 83555
Mailing address
PO Box 89
Winchester, ID 83555-0089
Phone (208) 791-8544
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 807346100 | Medicaid | ID | |
| 806910400 | Medicaid | ID | |
| 806984800 | Medicaid | ID | |
| 807384700 | Medicaid | ID | |
| 806983200 | Medicaid | ID |
Other providers in Winchester, ID
- Antone Counseling and Consulting Services, LLC
- Albana Antone
- Caregiving in Home LLC.
- Lakeside Residential Care Inc
- Tara Lee Lawrence
All providers in Winchester, ID · Marriage & Family Therapist in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 8, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.