Timothy John Anderson

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Mason City, IA

NPI 1154037117 · NPPES record last updated Jan 24, 2023

Key facts

NPI
1154037117
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
T23009 (IA)
Practice address
320 N Eisenhower Ave
Mason City, IA 50401-1521
Phone
(641) 424-0783
NPI assigned
Jan 24, 2023
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

LicenseStateTypeSpecialty
T23009IAMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X T23009 IA Yes

Addresses

Primary practice location

320 N Eisenhower Ave
Mason City, IA 50401-1521

Mailing address

320 N Eisenhower Ave
Mason City, IA 50401-1521

Other providers in Mason City, IA

All providers in Mason City, IA · Addiction (Substance Use Disorder) Counselor in Iowa

Sources for this page

Verify at the official NPI Registry.