Stephen Anderson
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Mansfield, OH
NPI 1720518319 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1720518319
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 163563 (OH)
- Practice address
- 680 Park Ave W.
Mansfield, OH 44906 - Phone
- (419) 528-5993
- Fax
- (567) 560-5486
- NPI assigned
- Jun 15, 2017
- Sex
- Male
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 163563 | OH | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 163563 | OH | Yes |
Addresses
Primary practice location
680 Park Ave W.
Mansfield, OH 44906
Mailing address
680 Park Ave W
Mansfield, OH 44906-3706
Phone (419) 528-5993
Other providers in Mansfield, OH
- Ashleigh E Anderson
- Bradley Anderson
- John Robert Anderson
- Maja-Lisa C Anderson
- Pauline V Anderson
- Tajee Anderson
- Velma F Anderson
- Andrew M. Gast, D.D.S., Inc.
- Heather Andrews
- Jennifer Lynn Andrews
All providers in Mansfield, OH · Addiction (Substance Use Disorder) Counselor in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. 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.