Patrick Anderson, LISAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

15174 Issued in AZ

Practice address

3930 N 30TH Ave
Phoenix, AZ 85017-4607

Phone

(623) 322-6143

Fax

(480) 781-4566

NPI assigned

Apr 1, 2022

Last updated

Sep 6, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• 2 Luv 1 Another Wellness & Care Center LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1376272534

  Addiction (Substance Use Disorder)

  NPD
• Helping Handz Counseling Services-Outpatient Treatment Cent

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1891395604
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1648771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1093455396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3930 N 30TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850174607",
            "telephone_number": "623-322-6143",
            "fax_number": "480-781-4566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3930 N 30TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850174607",
            "telephone_number": "623-322-6143",
            "fax_number": "480-781-4566"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2222 N 24th St",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850082716",
            "country_code": "US",
            "telephone_number": "602-681-7188",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "PATRICK",
        "credential": "LISAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-01",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "15174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Theranest",
            "affiliation": "N",
            "address_1": "2222 N 24th St",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850082716",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ADVANCEDMD",
            "affiliation": "N",
            "endpointDescription": "EMR/EHR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3930 N 30th Ave",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850174607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michael Anderson, MD
• Michael James Anderson, PHARM.D.
• Michelle Marie Anderson
• Monica Anderson, LMSW
• Norma Anderson
• Rachel Anderson, BACB
• Rochelle Anderson
• Samuel Michal Anderson, MD
• Sara C Anderson, PHARM.D.
• Sarah Anderson, PMHNP-BC

• Addiction (Substance Use Disorder) Counselor in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Addiction (Substance Use Disorder) Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.