Active NPI
Kelly S Anderson, MA
- Professional Counselor
- Vancouver, WA
National Provider Identifier
1386145274
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- MC61499734
- Practice address
- 7600 NE 41St St Ste 200
Vancouver, WA 98662-6772 - Phone
- (564) 208-0023
- NPI assigned
- Feb 26, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | |||
| Professional Counselor | 101YP2500X | MC61499734 | WA | Primary |
Addresses
Primary practice location
7600 NE 41St St Ste 200
Vancouver, WA 98662-6772
Mailing address
100 N Howard St Ste W
Spokane, WA 99201-0508
Phone (564) 208-0023
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MC61499734 | WA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705017600000",
"number": "1386145274",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 N HOWARD ST STE W",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992010508",
"telephone_number": "564-208-0023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7600 NE 41ST ST STE 200",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986626772",
"telephone_number": "564-208-0023"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "KELLY",
"middle_name": "S",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-26",
"last_updated": "2024-01-12",
"certification_date": "2024-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WA",
"license": "MC61499734",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.