Anderson, Mark Shane

Anderson, Mark Shane is an individual health care provider with primary practice located at 4105 Kirkman St , Lake Charles LA 70607-4603. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Anderson, Mark Shane can be contacted via phone (337) 475-8738.

Contact Information

Primary practice address
4105 Kirkman St Lake Charles LA 70607-4603
Phone: (337) 475-8738
Fax: (337) 475-8054
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 2251 CIT Louisiana

Profile Details

NPI number 1184825705
LBN Legal business name Anderson, Mark Shane
Credentials RAC, CCDP, CCGC
Entity Individual
Sole proprietor 1 No
Enumeration date May 30th, 2007
Last updated Sep 23rd, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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