Blair Rae-Nicole Anderson
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Jacksonville, FL
NPI 1225973126 · NPPES record last updated Apr 20, 2026
Key facts
- NPI
- 1225973126
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- Practice address
- 590 Ellis Rd S BLDG 4
Jacksonville, FL 32254-3555 - Phone
- (877) 284-7074
- NPI assigned
- Apr 20, 2026
- Sex
- Female
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Yes |
Addresses
Primary practice location
590 Ellis Rd S BLDG 4
Jacksonville, FL 32254-3555
Mailing address
590 Ellis Rd S BLDG 4
Jacksonville, FL 32254-3555
Phone (877) 284-7074
Other providers in Jacksonville, FL
- Sandra Jean Anderson-Jones
- Aimee Diane Anderson
- Andrew Robert Anderson
- Anne M Anderson
- Atoya Cierra Anderson
- Bryan T Anderson
- Caitlin Anderson
- Caroline Anderson
- Carrie Nicole Anderson
- Chelsey Anderson
All providers in Jacksonville, FL · Addiction (Substance Use Disorder) Counselor in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2026. 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.