Anderson, Patrick

Anderson, Patrick is an sole proprietor health care provider with primary practice located at 3930 N 30Th Ave , Phoenix AZ 85017-4607. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Anderson, Patrick can be contacted via phone (623) 322-6143.

Contact Information

Primary practice address
3930 N 30Th Ave Phoenix AZ 85017-4607
Phone: (623) 322-6143
Fax: (480) 781-4566
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 15174 Arizona

Profile Details

NPI number 1093455396
LBN Legal business name Anderson, Patrick
Credentials LISAC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 1st, 2022
Last updated Sep 6th, 2022 - about 2 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 1093455396 NPPES
Arizona MEDICAID 091903

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