John C Anderson, LPC
Individual provider Active NPI Professional Counselor · Cape Girardeau, MO
NPI 1386739712 · NPPES record last updated Dec 27, 2011
Key facts
- NPI
- 1386739712
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 002659 (MO)
- Practice address
- 402 S Silver Springs Road
Cape Girardeau, MO 63703 - Phone
- (573) 334-1100
- Fax
- (573) 651-4345
- NPI assigned
- Oct 3, 2006
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002659 | MO | MD | Professional Counselor |
Interoperability endpoints
- mrivero@direct.lumeris.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 002659 | MO | Yes |
Addresses
Primary practice location
402 S Silver Springs Road
Cape Girardeau, MO 63703
Mailing address
402 S Silver Springs Road
Cape Girardeau, MO 63703
Phone (573) 334-1100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 493976401 | Medicaid | MO | |
| 10118SW | Other | MO | BLUE CROSS BLUE SHIELD |
| 469416 | Other | MO | HEALTHLINK |
Other providers in Cape Girardeau, MO
- Khadrah M Alsomali
- Joy Amann
- Jesal Suresh Amin
- Amity Health Services, LLC
- Brandon Lee Anderson
- McKynlee Paige Anderson
- Shannon N Anderson
- Aleksey Aleksandrovich Androsov
- Anesthesia Associates of Cape Girardeau
- Anesthesia Associates of Cape Girardeau PC
All providers in Cape Girardeau, MO · Professional Counselor in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 27, 2011. 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.