Anderson, Kevin Scott

Anderson, Kevin Scott is an sole proprietor health care provider with primary practice located at 111 N Main St Ste 205 , Austin MN 55912-3474. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / School. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Anderson, Kevin Scott can be contacted via phone (507) 440-0134.

Contact Information

Primary practice address
111 N Main St Ste 205 Austin MN 55912-3474
Phone: (507) 440-0134
Fax: (855) 748-3132
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X LP3823 Minnesota
Behavioral Health & Social Service Providers / School 103TS0200X LP3823 Minnesota

Profile Details

NPI number 1669867511
LBN Legal business name Anderson, Kevin Scott
Credentials ED.S., LP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 30th, 2015
Last updated Mar 17th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669867511 NPPES
Minnesota MEDICAID 38734400

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