Melissa Marie Anderson, LPC
Individual provider Active NPI Professional Counselor · Kodiak, AK
NPI 1679100515 · NPPES record last updated Mar 23, 2020
Key facts
- NPI
- 1679100515
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 138652 (AK)
- Practice address
- 3449 E Rezanof Dr
Kodiak, AK 99615-6952 - Phone
- (907) 486-9844
- Fax
- (907) 486-9801
- NPI assigned
- Mar 23, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Kodiak Area Native Association
Practice addresses (Care Compare)
323 Carolyn St
Kodiak, AK 99615-6376
Phone (907) 486-9800
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240605000196 | TX | Practitioner - Mental Health Counselor | 7810439940 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 138652 | AK | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kodiak Area Native Association | Current |
Accepting new patients | |
| Kodiak Area Native Association | Past |
Accepting new patients | |
| Kodiak Area Native Association | Past |
Accepting new patients |
Locations
3449 E Rezanof Dr
Kodiak, AK 99615
Phone (907) 486-9800
323 Carolyn St
Kodiak, AK 99615
Phone (907) 486-7380
2414 Mill Bay Rd
Kodiak, AK 99615
Phone (907) 486-7326
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 138652 | AK | Yes |
Addresses
Primary practice location
3449 E Rezanof Dr
Kodiak, AK 99615-6952
Mailing address
3449 E Rezanof Dr
Kodiak, AK 99615-6952
Phone (907) 486-9844
Other providers in Kodiak, AK
- Diane Alonzo
- Heidi Alonzo
- Donene Amodo
- Seraphima Anaya
- Anchorage Sleep Center, LLC Dba Kodiak Sleep Center
- Taylor Anderson
- Carole Vaialufi Arcelay
- Arctic Chiropractic and Physical Medicine Kodiak
- Arctic Physical Therapy Services, Inc.
- Baylee Armstrong
All providers in Kodiak, AK · Professional Counselor in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 23, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.