Marcus Maurice Anderson, MHPP
Individual provider Active NPI Case Manager/Care Coordinator · Pine Bluff, AR
NPI 1285879007 · NPPES record last updated Oct 14, 2015
Key facts
- NPI
- 1285879007
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- Practice address
- 620 S Laurel St
Pine Bluff, AR 71601-4859 - Phone
- (870) 534-4900
- Fax
- (870) 534-4906
- NPI assigned
- Dec 8, 2008
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Case Manager/Care Coordinator | 171M00000X | Yes |
Addresses
Primary practice location
620 S Laurel St
Pine Bluff, AR 71601-4859
Mailing address
620 S Laurel St
Pine Bluff, AR 71601-4859
Phone (870) 534-4900
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 180635526 | Medicaid | AR |
Other providers in Pine Bluff, AR
- Muazzum Aman
- Ahmed Yahya Amin
- Amy Boast Cahill, M.D., P.a.
- Monica M Anderson-Allen
- Jared Duncan Anderson
- Terry Anderson
- Yasheika Ania
- Daniel E Ansley
- Adeel Anwar
- Karen Marie Appleget
All providers in Pine Bluff, AR · Case Manager/Care Coordinator in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 14, 2015. 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.