Pamela Jean Anderson, LADC
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Otsego, MN
NPI 1417526567 · NPPES record last updated Jun 23, 2021
Key facts
- NPI
- 1417526567
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 303440 (MN)
- Practice address
- 9245 Quantrelle Ave NE
Otsego, MN 55330-0168 - Phone
- (763) 746-9492
- Fax
- (763) 746-3685
- NPI assigned
- Jun 23, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 303440 | MN | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Support Services Inc. | Current |
Accepting new patients | |
| Nystrom & Associates, LTD | Current |
Accepting new patients |
Locations
9245 Quantrelle Ave NE
Otsego, MN 55330
Phone (763) 308-8619
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 303440 | MN | Yes |
Addresses
Primary practice location
9245 Quantrelle Ave NE
Otsego, MN 55330-0168
Mailing address
9245 Quantrelle Ave NE
Otsego, MN 55330-0168
Phone (763) 746-9492
Other providers in Otsego, MN
- Judith M Anderson
- Kelsey Anderson
- Kristin Marie Anderson
- Kurt David Anderson
- Nicole Catherine Anderson
- Zachary Peter Arntson
- Artura Dental
- Kevin Alan Augustin
- Avalyn Care LLC
- Rebecca L Bachmeier
All providers in Otsego, MN · Addiction (Substance Use Disorder) Counselor in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 23, 2021. 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.