Martha Keenan Anderson, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

178.018609 Issued in IL

Practice address

310 W Plaza Dr
Carterville, IL 62918-1980

Phone

(618) 985-4434

NPI assigned

Jul 5, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Martha J Anderson Other name

Medicare fee-for-service enrollment

Enrolled in IL

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 1

Specialty

Mental Health Counselor

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: martha.anderson.1@26231.direct.athenahealth.com

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.

• Integrated Health of Southern Illinois, LTD.

  • Sports Medicine (Family Medicine) Physician
  • Harrisburg, IL
  • NPI 1982738274
  Medicare reassignment

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

{
    "created_epoch": "1688515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1972280501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1503 W WALNUT ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629012259",
            "telephone_number": "708-657-8876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 W PLAZA DR",
            "city": "CARTERVILLE",
            "state": "IL",
            "postal_code": "629181980",
            "telephone_number": "618-985-4434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "MARTHA",
        "middle_name": "KEENAN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-05",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.018609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARTHA",
            "last_name": "ANDERSON",
            "middle_name": "J",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Betty Akamani, MS
• Rae Lynn Allen
• Zahra Alsultan, MD
• Esraa Aly, MSW
• Alyssa Anderson
• Mary K Anderson, MSW,LSW
• Robert Anderson
• Courtney Alyse Aquino, MA
• Dana Leigh Arnold, M.S. CCC-SLP
• Alexander J Ashby

• Professional Counselor in Carterville, IL
• Providers in Carterville, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 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.