Addie W Anderson, LCPC

Key facts

NPI

1962643650

Entity type

Individual (NPI type 1)

Primary specialty

Professional Counselor 101YP2500X

License

180005782 (IL)

Practice address

7326 Harrison St
Forest Park, IL 60130-2017

Phone

(708) 870-6255

NPI assigned

Mar 10, 2009

Sex

Female

Sole proprietor

Yes

Organizations & group practices 1

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.

• Begin Within Counseling & Coaching Services, Inc. Professional Counselor · Oak Park, IL · NPI 1548704901
  NPD (past) Authorized official PROFESSIONAL

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 13, 2009.

{
    "created_epoch": "1236643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236902400000",
    "number": "1962643650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 S TAYLOR AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603041621",
            "telephone_number": "708-870-6255",
            "fax_number": "708-524-8492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7326 HARRISON ST",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601302017",
            "telephone_number": "708-870-6255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ADDIE",
        "middle_name": "W",
        "name_prefix": "Mrs.",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-10",
        "last_updated": "2009-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180005782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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