Mary Lu Anderson, LCSW, RN, CSAC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

973-123 Issued in WI

Practice address

5013 E Buckeye Rd
Madison, WI 53716-2301

Phone

(608) 222-8654

NPI assigned

Dec 7, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1196985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196985600000",
    "number": "1194908673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5013 E BUCKEYE RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537162301",
            "telephone_number": "608-222-8654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5013 E BUCKEYE RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537162301",
            "telephone_number": "608-222-8654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "MARY LU",
        "credential": "LCSW, RN, CSAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-07",
        "last_updated": "2007-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "1911-132",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "973-123",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "41435-030",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39295500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristen L Anderson, CRNA
• Lindsey Anderson, LMFT
• Madeleine Anderson
• Marilee Anderson
• Mark R Anderson, L.P.C.
• Matthew J Anderson, M.D.
• Megan Anderson
• Natalie Marie Anderson
• Nathan Anderson
• Patricia Anderson, MSSW

• All providers in Madison, WI
• Mental Health Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2007; 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.