KEVIN JOSEPH ANDERSON NPI 1134556624

NPI Information

NPI: 1134556624
Provider Name: KEVIN JOSEPH ANDERSON
Classification: Counselor - 101Y00000X
Entity Type: Individual
Address:
520 DUDLEY ST
ROXBURY, MA
ZIP 02119
Phone: (508) 208-4656
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Kevin Joseph Anderson is a counselor in Roxbury, MA. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. Kevin Joseph Anderson NPI is 1134556624. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

520 DUDLEY ST
ROXBURY, MA
ZIP 02119-769
Phone: (508) 208-4656

The enumeration date for this NPI number is 9/30/2013 and was last updated on 11/15/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101Y00000X	Counselor		S40107772	MASSACHUSETTS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1004745	OTHER	MASSACHUSETTS	NHP
2	M18633	OTHER	MASSACHUSETTS	BCBS
3	1303287	OTHER	MASSACHUSETTS	MBHP
4	99618201	OTHER	MASSACHUSETTS	NETWORTH HEALTH
5	042611055	OTHER	MASSACHUSETTS	TAX ID
6	1303287	MEDICAID	MASSACHUSETTS
7	0000023532	OTHER	MASSACHUSETTS	BMC
8	Y10074	MEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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