Provider Demographics
NPI:1841662988
Name:ANDERSON, NICHOLAS HOFFMAN (MA, LCPC, CAADC)
Entity type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:HOFFMAN
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:MA, LCPC, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 W 15TH ST
Mailing Address - Street 2:UNIT 409
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60608-1882
Mailing Address - Country:US
Mailing Address - Phone:612-219-8876
Mailing Address - Fax:
Practice Address - Street 1:2913 N COMMONWEALTH AVE
Practice Address - Street 2:6TH FLOOR
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-6211
Practice Address - Country:US
Practice Address - Phone:847-493-3517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-28
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)