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1457574527

NPI Code Detail

MEDICARE: MR. PERRY J ANDERSON JR. MSW

MEDICARE: MR. PERRY J ANDERSON JR. MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	6798-123	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1258073	OTHER	WI	ARAZ INSURANCE
3	2068111	OTHER	WI	CIGNA INSURANCE
4	338871	OTHER	WI	TRI CARE INSURANCE
5	P 12027501	OTHER	WI	WPPN INSURANCE
6	84 81085	OTHER	WI	MEDICA INSURANCE
7	373595	OTHER	WI	MHN HMC INSURANCE
8	37F39PE	OTHER	WI	BCBS MN INSURANCE
9	1026794	OTHER	WI	PREFERRED ONE INSURANCE

General Provider Information

NPI Number	:	1457574527
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PERRY J ANDERSON JR. MSW

Provider Business Mailing Address
First Line	:	440 105TH ST
Second Line	:
City	:	AMERY
State	:	WI
Zip	:	54001-4010
Country	:	US
Telephone Number	:	715-268-5165
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 POLK COUNTY PLZ
Second Line	:	SUITE 50
City	:	BALSAM LAKE
State	:	WI
Zip	:	54810-9071
Country	:	US
Telephone Number	:	715-485-8445
Fax Number	:	715-485-8490

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2007
Last Update Date	:	08/02/2010

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Directions to “ MR. PERRY J ANDERSON JR. MSW” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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