Anderson, Mary Lu

Anderson, Mary Lu is an individual health care provider with primary practice located at 5013 E Buckeye Rd , Madison WI 53716-2301. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Nursing Service Providers / Registered Nurse. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Anderson, Mary Lu can be contacted via phone (608) 222-8654.

Contact Information

Primary practice address
5013 E Buckeye Rd Madison WI 53716-2301
Phone: (608) 222-8654
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 1911-132 Wisconsin
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 973-123 Wisconsin
Nursing Service Providers / Registered Nurse 163W00000X 41435-030 Wisconsin

Profile Details

NPI number 1194908673
LBN Legal business name Anderson, Mary Lu
Credentials LCSW, RN, CSAC
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 7th, 2007
Last updated Dec 7th, 2007 - about 17 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 1194908673 NPPES
Wisconsin MEDICAID 39295500

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