Nicholas Hoffman Anderson, M.A., LCPC, CAADC
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Chicago, IL
NPI 1841662988 · NPPES record last updated Sep 20, 2016
Key facts
- NPI
- 1841662988
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- Practice address
- 2913 N Commonwealth Ave
6TH Floor
Chicago, IL 60657-6211 - Phone
- (847) 493-3517
- NPI assigned
- Oct 28, 2015
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Healthwise Psychology PA
Practice addresses (Care Compare)
18205 45TH Ave N
Plymouth, MN 55446-4551
Phone (763) 400-7828
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240226002704 | MN | Practitioner - Mental Health Counselor | 3870938293 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2024 | MN | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healthwise Psychology, PA | Current |
Accepting new patients | |
| Scott M Yarosh, LLC | Past |
Accepting new patients |
Locations
11280 86th Ave N
Maple Grove, MN 55369
Phone (763) 400-7828
18205 45th Ave N
Ste C
Plymouth, MN 55446
Phone (651) 478-4099
18205 45th Ave N
Plymouth, MN 55446
Phone (763) 400-7828
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Yes |
Addresses
Primary practice location
2913 N Commonwealth Ave
6TH Floor
Chicago, IL 60657-6211
Mailing address
1000 W 15TH St
Unit 409
Chicago, IL 60608-1882
Phone (612) 219-8876
Other providers in Chicago, IL
- Melanie Anne Anderson
- Michelle E Anderson
- Myah Elizabeth Anderson
- Nancy J Anderson
- Nathaniel Bo Anderson
- Noah Anderson
- Oscar Anderson
- Peyton Elizabeth Anderson
- Proctor Anderson
- Quiana Anderson
All providers in Chicago, IL · Addiction (Substance Use Disorder) Counselor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 20, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.