Teresa M Anderson, LMHC, CADC

Individual provider Active NPI Mental Health Counselor · Fort Dodge, IA

NPI 1891925293 · NPPES record last updated Oct 9, 2023

Key facts

NPI
1891925293
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
001287 (IA)
Practice address
1728 Central Ave Ste 14
Fort Dodge, IA 50501-4200
Phone
(515) 955-1836
Fax
(515) 955-7115
NPI assigned
Jul 20, 2009
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
07061IAMDAddiction (Substance Use Disorder) Counselor
001287IAMDCounseling Psychologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 07061 IA
Mental Health Counselor 101YM0800X
Mental Health Counselor 101YM0800X 001287 IA Yes

Addresses

Primary practice location

1728 Central Ave Ste 14
Fort Dodge, IA 50501-4200

Mailing address

1728 Central Ave Ste 14
Fort Dodge, IA 50501-4200
Phone (515) 955-1836

Other identifiers

IdentifierTypeStateIssuer
0159608MedicaidIA
07466OtherIAWELLMARK BC/BS

Other providers in Fort Dodge, IA

All providers in Fort Dodge, IA · Mental Health Counselor in Iowa

Sources for this page

Verify at the official NPI Registry.