person
Mark W. Anderson, LADC
Addiction (Substance Use Disorder) Counselor in Grand Rapids, Minnesota
NPI 1225215122

Mark W. Anderson is an Addiction (Substance Use Disorder) Counselor based in Grand Rapids, MN and is specialized in Addiction (Substance Use Disorder). Mark W. Anderson practices in Grand Rapids, MN and has the professional credentials of LADC. The NPI Number for Mark W. Anderson is 1225215122 and holds a License No. 302045 (Minnesota).

The current practice location address for Mark W. Anderson is 1215 Se 7Th Ave, Grand Rapids, MN and can be reached out via phone at 218-327-1105.

Location: 1215 Se 7Th Ave, Grand Rapids, MN, 55744-4201
person
Provider Profile Details
NPI Number
1225215122
Provider Name
Mark W. Anderson
Credential
LADC
Provider Entity Type
Individual
Gender
Male
Address
1215 Se 7Th Ave, Grand Rapids, MN, 55744-4201
Phone Number
218-327-1105
Fax Number
Provider Enumeration Date
01/23/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
84-10374 01 MN UBH
1021875 01 MN PREFERRED ONE
8199PNO 01 MS BCBS
institution
Provider Business Practice Location Address Details
Address
1215 Se 7Th Ave
City
State
Zip
55744-4201
Phone Number
218-327-1105
Fax Number
person
Provider Business Mailing Address Details
Address
1215 Se 7Th Ave
City
State
Zip
55744-4201
Phone Number
218-327-1105
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
302045 (Minnesota)
Definition
Definition to come...
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