Roberta J Anderson, LAC
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Jamestown, ND
NPI 1306903547 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1306903547
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 1329 (ND)
- Practice address
- 520 3Rd St NW
Jamestown, ND 58401-2968 - Phone
- (701) 253-6300
- Fax
- (701) 253-6400
- NPI assigned
- Jan 3, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1329 | ND | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Central Human Service Center | Past |
Accepting new patients | |
| South Central Behavioral Health Clinic | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1329 | ND | Yes |
Addresses
Primary practice location
520 3Rd St NW
Jamestown, ND 58401-2968
Mailing address
PO Box 2055
Jamestown, ND 58402-2055
Phone (701) 253-6300
Other providers in Jamestown, ND
- Dennis O Anderson
- Edward Andrew Anderson
- Erin M Anderson
- Jason Anderson
- Kelly Anderson
- Susan Jean Anderson
- Tracy Anderson
- Casey Andrews
- Mason Ankenbauer
- Anne Carlsen Center
All providers in Jamestown, ND · Addiction (Substance Use Disorder) Counselor in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.