| Mary Anderson Lcsw Pc | |
|
104 S Cascade Ave Suite203 Colorado Springs CO 80903-2250 | |
| (719) 475-0292 | |
| Not Available |
| Full Name | Mary Anderson Lcsw Pc |
|---|---|
| Speciality | Counselor |
| Location | 104 S Cascade Ave, Colorado Springs, Colorado |
| Authorized Official Name and Position | Mary S. Anderson (PRESIDENT) |
| Authorized Official Contact | 7194750292 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mary Anderson Lcsw Pc 104 S Cascade Ave Suite 203 Colorado Springs CO 80903-2250 Ph: (719) 475-0292 | Mary Anderson Lcsw Pc 104 S Cascade Ave Suite203 Colorado Springs CO 80903-2250 Ph: (719) 475-0292 |
| NPI Number | 1508906553 |
|---|---|
| Provider Enumeration Date | 02/07/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 8628042033 |
|---|---|
| Medicare Enrollment ID | O20040823000422 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508906553 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 9892353189 (Colorado) | Primary |
| Provider Name | Mary S Anderson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194815753 PECOS PAC ID: 6204808561 Enrollment ID: I20040809000481 |
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