Active NPI
Kyle Anderson
- Professional Counselor
- Bucyrus, OH
National Provider Identifier
1750800017
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Practice address
- 2458 Stetzer Rd
Bucyrus, OH 44820-2066 - Phone
- (419) 562-2000
- NPI assigned
- Sep 18, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | OH | Primary | |
| Case Manager/Care Coordinator | 171M00000X |
Addresses
Primary practice location
2458 Stetzer Rd
Bucyrus, OH 44820-2066
Mailing address
1404 Park Ave W
Ontario, OH 44906-2719
Phone (419) 522-6191
Other practice location 1
675 Bartson Rd
Fremont, OH 43420-9672
Phone (419) 332-5524
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Undefined Non-Physician Type (Specify)
- Education
- Other, 2018
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1404 Park Ave W
Suite 2
Mansfield, OH 44906-2633
2257 Lobelia Ave
Upland, CA 91784-7386
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773878400000",
"number": "1750800017",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1404 PARK AVE W",
"city": "ONTARIO",
"state": "OH",
"postal_code": "449062719",
"telephone_number": "419-522-6191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2458 STETZER RD",
"city": "BUCYRUS",
"state": "OH",
"postal_code": "448202066",
"telephone_number": "419-562-2000"
}
],
"practiceLocations": [
{
"address_1": "675 Bartson Rd",
"address_purpose": "LOCATION",
"city": "Fremont",
"state": "OH",
"postal_code": "434209672",
"country_code": "US",
"telephone_number": "419-332-5524",
"fax_number": "419-332-7581",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ANDERSON",
"first_name": "KYLE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-09-18",
"last_updated": "2026-03-19",
"certification_date": "2026-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OH",
"license": null,
"primary": true
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bucyrus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.