Ross Anderson, CADC-I

Key facts

NPI

1053947739

Entity type

Individual (NPI type 1)

Primary specialty

Addiction (Substance Use Disorder) Counselor 101YA0400X

License

02461-I (NV)

Practice address

4528 W Craig Rd Ste 110
North Las Vegas, NV 89032-2505

Phone

(702) 647-6433

NPI assigned

Mar 13, 2020

Sex

Male

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 13, 2020.

{
    "created_epoch": "1584057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1053947739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "188 TIMELESS VIEW CT",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890125568",
            "telephone_number": "702-544-3269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4528 W CRAIG RD STE 110",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890322505",
            "telephone_number": "702-647-6433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ROSS",
        "credential": "CADC-I",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-13",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NV",
            "license": "02461-I",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Las Vegas, NV

• Courtney Noel Anderson
• Emily Rose Anderson, OTR/L
• Jameisha Denise Anderson
• Larry Anderson
• Matthew B. Anderson, D.C., P.C.
• Stephanie Lynn Anderson, MSOTR
• Jennifer Andreas
• Andrew K Mensah MD a PC
• Carol Andrews
• Maurice Andrews

All providers in North Las Vegas, NV · Addiction (Substance Use Disorder) Counselor in Nevada