Individual
MR. SCOTT KAY ANDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
343 E 4TH N, SUITE 244, REXBURG, ID 83440-6002
(208) 356-0088
(208) 524-3738
Mailing address
343 E 4TH N, SUITE 244, REXBURG, ID 83440-6002
(208) 356-0088
(208) 524-3738
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC2823
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164723334
—
ID
01
—
710C6005
RBH
ID
01
—
D214391
VALUE OPTIONS
ID
01
—
Q7348
BLUE CROSS
ID
01
—
Q7699
BLUE CROSS
ID
Enumeration date
07/27/2006
Last updated
12/08/2011
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