Individual provider Active NPI

Allan Neil Anderson, L.I.C.S.W.

  • Clinical Social Worker
  • Lowell, MA
National Provider Identifier
1720186505
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1016216 Issued in MA
Practice address
704 Rogers St
Lowell, MA 01852-4338
Phone
(978) 937-2696
Fax
(978) 970-2922
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1016216 MA Primary

Addresses

Primary practice location

704 Rogers St
Lowell, MA 01852-4338

Mailing address

704 Rogers St
Lowell, MA 01852-4338
Phone (978) 937-2696

Other identifiers 2

IdentifierTypeStateIssuer
712815OtherMATUFTS HEALTH PLANS
P04692OtherMABLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040603000802 MA Practitioner - Clinical Social Worker 3072595099 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pathways Counseling Associates, Inc.Group PAC ID 8527030907, 2 clinicians

Practice addresses (Care Compare)

134 Middle St
Suite 340
Lowell, MA 01852-1878
Phone (978) 937-2696

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720186505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 ROGERS ST",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018524338",
            "telephone_number": "978-937-2696",
            "fax_number": "978-970-2922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 ROGERS ST",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018524338",
            "telephone_number": "978-937-2696",
            "fax_number": "978-970-2922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ALLAN",
        "middle_name": "NEIL",
        "credential": "L.I.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1016216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLANS",
            "identifier": "712815",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "P04692",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowell, MA

Sources for this page

Verify at the official NPI Registry.