Paige Anderson
Individual provider Active NPI Peer Specialist · Bixby, OK
NPI 1235855164 · NPPES record last updated Nov 21, 2022
Key facts
- NPI
- 1235855164
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Peer Specialist 175T00000X
- Practice address
- 2379 E 140TH St S
Bixby, OK 74008-4844 - Phone
- (918) 752-8239
- NPI assigned
- Oct 12, 2022
- Sex
- Male
- Sole proprietor
- Yes
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 | |||
| Peer Specialist | 175T00000X | Yes |
Addresses
Primary practice location
2379 E 140TH St S
Bixby, OK 74008-4844
Mailing address
2379 E 140TH St S
Bixby, OK 74008-4844
Phone (918) 752-8239
Other providers in Bixby, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 21, 2022. 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.