Samantha Kelly Anderson, CDPT

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CO60912422 Issued in WA

Practice address

1601 E Fourth Plain Blvd
Vancouver, WA 98661-3713

Phone

(360) 397-8246

Fax

(360) 397-8250

NPI assigned

Dec 31, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1546214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546214400000",
    "number": "1164994109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "971 4TH ST",
            "city": "WASHOUGAL",
            "state": "WA",
            "postal_code": "986711001",
            "telephone_number": "136-083-1531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 E FOURTH PLAIN BLVD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986613713",
            "telephone_number": "360-397-8246",
            "fax_number": "360-397-8250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "SAMANTHA",
        "middle_name": "KELLY",
        "name_prefix": "Ms.",
        "credential": "CDPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-31",
        "last_updated": "2018-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CO60912422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Anderson
• Rebecca Jane Anderson, LMP
• Regina Marie Anderson, SLP
• Rob Elmer William Anderson
• Ryan John Anderson, PH.D., LMFT
• Shaun Robert Anderson, R.C., C.D.P.T.
• Sophie Jean Anderson, CSWA
• Suanne Anderson
• Tessa Mae Anderson
• Victoria Marie Anderson

• Addiction (Substance Use Disorder) Counselor in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2018; 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.