Joseph John Andersen, M.S. LMFT

Individual provider Active NPI Marriage & Family Therapist · Meridian, ID

NPI 1174847446 · NPPES record last updated Mar 16, 2010

Key facts

NPI
1174847446
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
4117 (ID)
Practice address
667 E Grouse CT
Meridian, ID 83646-4414
Phone
(208) 283-9888
NPI assigned
Mar 16, 2010
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
4117IDMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Siena Einerprises, LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 4117 ID Yes

Addresses

Primary practice location

667 E Grouse CT
Meridian, ID 83646-4414

Mailing address

667 E Grouse CT
Meridian, ID 83646-4414
Phone (208) 283-9888

Other providers in Meridian, ID

All providers in Meridian, ID · Marriage & Family Therapist in Idaho

Sources for this page

Verify at the official NPI Registry.