John Kirk Anderson, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

1192 Issued in NM

Practice address

920 W Broadway St
Hobbs, NM 88240-5529

Phone

(505) 393-3168

Fax

(505) 397-4659

NPI assigned

Nov 7, 2006

Last updated

Sep 8, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Community Outreach Resources, LLC

  • Professional Counselor
  • Hobbs, NM
  • NPI 1942684402
  Authorized official Same address or phone

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220832000000",
    "number": "1699844407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 N TURNER",
            "address_2": "SUITE 101A",
            "city": "HOBBS",
            "state": "NM",
            "postal_code": "882404309",
            "telephone_number": "575-390-2529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 W BROADWAY ST",
            "city": "HOBBS",
            "state": "NM",
            "postal_code": "882405529",
            "telephone_number": "505-393-3168",
            "fax_number": "505-397-4659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JOHN",
        "middle_name": "KIRK",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2008-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "1192",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "13788",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "46300",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Hobbs, NM
• Providers in Hobbs, NM by specialty
• Professional Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2008; 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.