Marvin Neil Anderson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW60539401 Issued in WA

Practice address

1200 Chesterly Dr Ste 100
Yakima, WA 98902-7339

Phone

(509) 712-2902

Fax

(509) 554-5595

NPI assigned

Dec 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TN, WA2 enrollments

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 2

Specialty

Clinical Social Worker

Education

University of Tennessee, HSC, College of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Comprehensive Healthcare

  • Community/Behavioral Health Agency
  • Yakima, WA
  • NPI 1073527453
  Medicare reassignment
• Spectrum Mental Health

  • Psychiatric/Mental Health Nurse Practitioner
  • Vancouver, WA
  • NPI 1356812614
  NPD
• Family Services of the Mid-South

  • Community/Behavioral Health Agency
  • Memphis, TN
  • NPI 1225103914
  NPD (past)

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1770645285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CHESTERLY DR STE 100",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989027339",
            "telephone_number": "509-712-2902",
            "fax_number": "509-554-5595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 CHESTERLY DR STE 100",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989027339",
            "telephone_number": "509-712-2902",
            "fax_number": "509-554-5595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "MARVIN",
        "middle_name": "NEIL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60539401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3925891",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD #",
            "identifier": "4110408",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS PROVIDER #",
            "identifier": "500566",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alejandro Amezcua
• Tina Amir, DMD
• Ashley Anderson
• Chante Christine Anderson, LMHC
• David M. Anderson, ARNPW
• Olivia Dawn Anderson
• Shane M Anderson, PHD
• Shelby Ruth Anderson, RN60201407
• Taylor Burke Anderson, DMD
• Timothy Anderson

• Clinical Social Worker in Yakima, WA
• Providers in Yakima, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; 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.

Verify at the official NPI Registry.