Ronda Anderson
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Bangor, ME
NPI 1104267954 · NPPES record last updated Jul 9, 2013
Key facts
- NPI
- 1104267954
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- CAC4364 (ME)
- Practice address
- 629 Main St
Bangor, ME 04401-6848 - Phone
- (207) 990-2870
- Fax
- (207) 990-2298
- NPI assigned
- Jul 9, 2013
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CAC4364 | ME | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CAC4364 | ME | Yes |
Addresses
Primary practice location
629 Main St
Bangor, ME 04401-6848
Mailing address
629 Main St
Bangor, ME 04401-6848
Other providers in Bangor, ME
- Christian Andersen
- Alec Anderson
- Jordan Christine Anderson
- Mae Anderson
- Mary E Anderson
- Shermane M Anderson
- Lea Andrew
- Emily R Andrews
- Michael J Andrick
- Napoleon Andriopulos
All providers in Bangor, ME · Addiction (Substance Use Disorder) Counselor in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2013. 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.