Erica Anderson
Individual provider Active NPI Mental Health Counselor · Melrose Park, IL
NPI 1659820355 · NPPES record last updated Sep 23, 2016
Key facts
- NPI
- 1659820355
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- NONE
- Practice address
- 1414 Main St
Melrose Park, IL 60160-3902 - Phone
- (708) 681-0073
- NPI assigned
- Sep 23, 2016
- Sex
- Female
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | NONE | Yes |
Addresses
Primary practice location
1414 Main St
Melrose Park, IL 60160-3902
Mailing address
1820 S 25TH Ave
Broadway, IL 60160
Phone (708) 681-0073
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All providers in Melrose Park, IL · Mental Health 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 Sep 23, 2016. 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.