Active NPI
Brian Edward Anderson, MS, LPC
- Mental Health Counselor
- Edmond, OK
National Provider Identifier
1104208891
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LPC07694
- Practice address
- 3001 E Memorial Rd
Edmond, OK 73013-7107 - Phone
- (405) 210-4596
- NPI assigned
- Jun 18, 2015
- Last updated
- Nov 28, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LPC07694 | OK | Primary |
Addresses
Primary practice location
3001 E Memorial Rd
Edmond, OK 73013-7107
Mailing address
8108 Ridge Creek Rd
Edmond, OK 73034-4472
Phone (405) 210-4596
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC07694 | OK | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701129600000",
"number": "1104208891",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8108 RIDGE CREEK RD",
"city": "EDMOND",
"state": "OK",
"postal_code": "730344472",
"telephone_number": "405-210-4596"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3001 E MEMORIAL RD",
"city": "EDMOND",
"state": "OK",
"postal_code": "730137107",
"telephone_number": "405-210-4596"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "BRIAN",
"middle_name": "EDWARD",
"credential": "MS, LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-06-18",
"last_updated": "2023-11-28",
"certification_date": "2023-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OK",
"license": "LPC07694",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Edmond, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.