Paul W. Anderson, PH.D.
Individual provider Active NPI Counseling Psychologist · Overland Park, KS
NPI 1235166604 · NPPES record last updated Mar 11, 2020
Key facts
- NPI
- 1235166604
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counseling Psychologist 103TC1900X
- License
- 1260 (KS)
- Practice address
- 8216 W 113TH Ter
Overland Park, KS 66210-2425 - Phone
- (913) 991-2302
- NPI assigned
- Jun 28, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 1979
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Paul W. Anderson, Inc.
Practice addresses (Care Compare)
8216 W 113TH Ter
Overland Park, KS 66210-2425
Phone (913) 991-2302
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220506001566 | KS | Practitioner - Clinical Psychologist | 5991940694 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 054 | KS | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Paul W. Anderson, Inc. | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 054 | KS | |
| Psychologist | 103T00000X | 1260 | KS | |
| Counseling Psychologist | 103TC1900X | 1260 | KS | Yes |
Addresses
Primary practice location
8216 W 113TH Ter
Overland Park, KS 66210-2425
Mailing address
8216 W 113TH Ter
Overland Park, KS 66210-2425
Phone (913) 991-2302
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://familymarriagecounselingkansascity.com/ | Direct |
Other providers in Overland Park, KS
- Lauren Anderson
- Marissa Anderson
- Maura Anderson
- Mercedes Anderson
- Michael W Anderson
- Robert Anderson
- Roger Linn Anderson
- Sandra L. Anderson
- Susan Joan Anderson
- Terry D Anderson
All providers in Overland Park, KS · Counseling Psychologist in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 11, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.