Kathryn Andersen
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Pekin, IL
NPI 1629464953 · NPPES record last updated Apr 14, 2015
Key facts
- NPI
- 1629464953
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- Practice address
- 3248 Vandever Ave
Pekin, IL 61554-6257 - Phone
- (309) 347-5579
- Fax
- (309) 347-4264
- NPI assigned
- Apr 14, 2015
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Yes | ||
| Social Worker | 104100000X |
Addresses
Primary practice location
3248 Vandever Ave
Pekin, IL 61554-6257
Mailing address
3248 Vandever Ave
Pekin, IL 61554-6257
Other providers in Pekin, IL
- Alan Burge DDS
- Elena Alcozer
- All Gastro LTD.
- Amber Altmix
- Jamaluddin F Amanullah
- Stacey Andersen
- J. Douglas Anderson
- Molly Bea Anderson
- Rachel Marie Anderson
- Mandi Larkin Arnsman
All providers in Pekin, IL · Addiction (Substance Use Disorder) Counselor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 14, 2015. 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.