Christian Anderson, CPC

Individual provider Active NPI Professional Counselor · Elko, NV

NPI 1053407635 · NPPES record last updated Oct 1, 2019

Key facts

NPI
1053407635
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
CP0001 (NV)
Practice address
380 Court St
Elko, NV 89801-3158
Phone
(915) 779-5600
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
CP0001NVMDProfessional Counselor
20065TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Amanecer Psychological Services Past Accepting new patients
Amanecer Psychological Services Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 20065 TX
Professional Counselor 101YP2500X CP0001 NV Yes

Addresses

Primary practice location

380 Court St
Elko, NV 89801-3158

Mailing address

349 Lakeport Dr
Spring Creek, NV 89815-6048
Phone (775) 299-9906

Other identifiers

IdentifierTypeStateIssuer
743025435OtherTXTRICARE
NM600035OtherNMVALUE OPTIONS
100516741MedicaidNV
84839LOtherTXBCBS OF TEXAS
1784936-01MedicaidTX

Other providers in Elko, NV

All providers in Elko, NV · Professional Counselor in Nevada

Sources for this page

Verify at the official NPI Registry.