Active NPI
Keri Jean Anderson, CADC, CPGC, CPGC-S
- Addiction (Substance Use Disorder) Counselor
- Las Vegas, NV
National Provider Identifier
1962921130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 0285
- Practice address
- 3852 Palos Verdes St
Las Vegas, NV 89119-6909 - Phone
- (702) 485-1300
- Fax
- (702) 485-1210
- NPI assigned
- Sep 19, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 0285 | NV | Primary |
Addresses
Primary practice location
3852 Palos Verdes St
Las Vegas, NV 89119-6909
Mailing address
635 Avenue H
Boulder City, NV 89005-2725
Phone (702) 499-2667
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0285 | NV | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1505779200000",
"number": "1962921130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "635 AVENUE H",
"city": "BOULDER CITY",
"state": "NV",
"postal_code": "890052725",
"telephone_number": "702-499-2667"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3852 PALOS VERDES ST",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891196909",
"telephone_number": "702-485-1300",
"fax_number": "702-485-1210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "KERI",
"middle_name": "JEAN",
"credential": "CADC, CPGC, CPGC-S",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-19",
"last_updated": "2017-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NV",
"license": "0285",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.