Patrick Anderson, LISAC
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Phoenix, AZ
NPI 1093455396 · NPPES record last updated Sep 6, 2022
Key facts
- NPI
- 1093455396
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 15174 (AZ)
- Practice address
- 3930 N 30TH Ave
Phoenix, AZ 85017-4607 - Phone
- (623) 322-6143
- Fax
- (480) 781-4566
- NPI assigned
- Apr 1, 2022
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Helping Handz Counseling Services-Outpatient Treatment Cent | Multi-Specialty | Current |
Accepting new patients |
| 2 Luv 1 Another Wellness & Care Center LLC | Addiction (Substance Use Disorder) | Current |
Accepting new patients |
Locations
2222 N 24th St
Phoenix, AZ 85008
Phone (602) 681-7188
3930 N 30th Ave
Phoenix, AZ 85017
Phone (623) 322-6143
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor |
101YA0400X | 15174 | AZ | Yes |
Addresses
Primary practice location
3930 N 30TH Ave
Phoenix, AZ 85017-4607
Mailing address
3930 N 30TH Ave
Phoenix, AZ 85017-4607
Phone (623) 322-6143
Other practice location 1
2222 N 24th St
Phoenix, AZ 85008-2716
Phone (602) 681-7188
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 091903 | Medicaid | AZ |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Theranest | ||
| CONNECT URL | ADVANCEDMD | Health Information Exchange (HIE) |
Other providers in Phoenix, AZ
- Michael Anderson
- Michael James Anderson
- Michelle Marie Anderson
- Monica Anderson
- Norma Anderson
- Rachel Anderson
- Rochelle Anderson
- Samuel Michal Anderson
- Sara C Anderson
- Sarah Anderson
All providers in Phoenix, AZ · Addiction (Substance Use Disorder) Counselor in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 6, 2022. 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.