Paul W. Anderson, Inc.

Organization Active NPI Clinical Social Worker · Bluffton, SC

NPI 1770525461 · NPPES record last updated Jul 20, 2016

Key facts

NPI
1770525461
Entity type
Organization (NPI type 2)
Primary specialty
Clinical Social Worker 1041C0700X
License
10335 (SC)
Legal business name
PAUL W. ANDERSON, INC.
Practice address
49 Westbury Park Way
Bluffton, SC 29910-8824
Phone
(843) 422-1408
Fax
(843) 815-2023
NPI assigned
Jun 10, 2006
Organization subpart
No

Authorized official

Name
Mrs. Pamela P. Anderson, MSW, LISW-CP NPI 1487682761
Title
Clinical Social Worker/Owner
Phone
(843) 422-1408

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in KS

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20140326000042 KS Part B Supplier - Clinic/Group Practice 1557592094 Receives reassigned benefits from 2 practitioners
Practice locations: Overland Park, KS

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker
Group: 193200000X MULTI-SPECIALTY GROUP
1041C0700X 10335 SC Yes
Clinical Social Worker
Group: 193200000X MULTI-SPECIALTY GROUP
1041C0700X 1055 KS

Addresses

Primary practice location

49 Westbury Park Way
Bluffton, SC 29910-8824

Mailing address

49 Westbury Park Way
Bluffton, SC 29910-8824
Phone (843) 422-1408

Other identifiers

IdentifierTypeStateIssuer
E270OtherSCPTAN

Other providers in Bluffton, SC

All providers in Bluffton, SC · Clinical Social Worker in South Carolina

Sources for this page

Verify at the official NPI Registry.