Provider Demographics
NPI:1508422619
Name:ANDERSON, BILL E (CACIII)
Entity Type:Individual
Prefix:
First Name:BILL
Middle Name:E
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:CACIII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17388 NATURE WALK TRL # 8-108
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-5262
Mailing Address - Country:US
Mailing Address - Phone:918-399-0330
Mailing Address - Fax:
Practice Address - Street 1:17388 NATURE WALK TRL # 8-108
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-5262
Practice Address - Country:US
Practice Address - Phone:918-399-0330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-14
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)