Grant Anderson

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

13488-R Issued in CA

Practice address

1024 N St
Eureka, CA 95501-2047

Phone

(707) 269-9566

Fax

(707) 442-1191

NPI assigned

Feb 11, 2020

Last updated

Feb 11, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Humboldt Recovery Center Inc.,

  • Substance Abuse Rehabilitation Facility
  • Eureka, CA
  • NPI 1073023107
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1581379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581379200000",
    "number": "1508498189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6310",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955026310",
            "telephone_number": "707-443-4237",
            "fax_number": "707-442-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1024 N ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955012047",
            "telephone_number": "707-269-9566",
            "fax_number": "707-442-1191"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1303 11th St",
            "address_purpose": "LOCATION",
            "city": "Eureka",
            "state": "CA",
            "postal_code": "955012028",
            "country_code": "US",
            "telephone_number": "707-444-6262 x92540",
            "fax_number": "707-442-1191",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "944 N St",
            "address_purpose": "LOCATION",
            "city": "Eureka",
            "state": "CA",
            "postal_code": "955012045",
            "country_code": "US",
            "telephone_number": "707-444-0514 x92540",
            "fax_number": "707-442-1191",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1219 10th St",
            "address_purpose": "LOCATION",
            "city": "Eureka",
            "state": "CA",
            "postal_code": "955012024",
            "country_code": "US",
            "telephone_number": "707-444-0514 x92540",
            "fax_number": "707-442-1191",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1116 9th St",
            "address_purpose": "LOCATION",
            "city": "Eureka",
            "state": "CA",
            "postal_code": "955011936",
            "country_code": "US",
            "telephone_number": "707-444-2033 x92540",
            "fax_number": "707-442-1191",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1120 9th St",
            "address_purpose": "LOCATION",
            "city": "Eureka",
            "state": "CA",
            "postal_code": "955011936",
            "country_code": "US",
            "telephone_number": "707-444-2033 x92540",
            "fax_number": "707-442-1191",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "905 L St",
            "address_purpose": "LOCATION",
            "city": "Eureka",
            "state": "CA",
            "postal_code": "955011943",
            "country_code": "US",
            "telephone_number": "707-444-2033 x92540",
            "fax_number": "707-442-1191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "GRANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-11",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "13488-R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Orion",
            "affiliation": "N",
            "endpointDescription": "Electronic Health Records",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1024 N St",
            "city": "Eureka",
            "state": "CA",
            "country_code": "US",
            "postal_code": "955012047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ann Rachel Anderson, MFT
• Breanna Marie Anderson, SLP-A
• Debra Kay Anderson, RN
• Elizabeth Anderson, LCSW
• Frank Anderson, RN
• James Rager Anderson
• John Raymond Anderson, MFT
• Kristen Leigh Anderson
• R'Delle Marie Anderson, PPS
• Sara Anderson

• Addiction (Substance Use Disorder) Counselor in Eureka, CA
• Providers in Eureka, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.