Mark R Anderson, L.P.C.
Individual provider Active NPI Professional Counselor · Madison, WI
NPI 1487822771 · NPPES record last updated Feb 20, 2008
Key facts
- NPI
- 1487822771
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 3075-125 (WI)
- Practice address
- 106 N Kenosha Dr
Madison, WI 53705-2633 - Phone
- (608) 257-7509
- NPI assigned
- Feb 20, 2008
- 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 |
|---|---|---|---|
| 3075-125 | WI | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 3075-125 | WI | Yes |
Addresses
Primary practice location
106 N Kenosha Dr
Madison, WI 53705-2633
Mailing address
106 N Kenosha Dr
Madison, WI 53705-2633
Phone (608) 257-7509
Other providers in Madison, WI
- Kortney L Anderson
- Kristen L Anderson
- Lindsey Anderson
- Madeleine Anderson
- Marilee Anderson
- Mary Lu Anderson
- Matthew J Anderson
- Megan Anderson
- Natalie Marie Anderson
- Nathan Anderson
All providers in Madison, WI · Professional Counselor in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 20, 2008. 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.