Individual
ERICA D ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APSW, CSAC
Contact information
Practice address
1125 W BADGER RD APT 6, MADISON, WI 53713
(608) 658-9985
Mailing address
PO BOX 639, THIENSVILLE, WI 53092-0639
(414) 247-9005
(414) 247-9004
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
18995130
WI
101YM0800X
Mental Health Counselor
Primary
127500121
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518501329
—
WY
Enumeration date
11/05/2019
Last updated
11/27/2020
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