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MR. MARK SHANE ANDERSON RAC, CCDP, CCGC
NPI 1184825705
Counselor - Addiction (Substance Use Disorder) in Lake Charles, LA

Active since May 30, 2007
4105 KIRKMAN ST, LAKE CHARLES, LA 70607(337) 475-8738(337) 475-8054 Get Directions Write a Review

NPPES record last updated: September 23, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Mark Shane Anderson Rac, Ccdp, Ccgc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. MARK SHANE ANDERSON RAC, CCDP, CCGC (NPI 1184825705) is an individual addiction (substance use disorder) provider in Lake Charles, Louisiana, licensed in Louisiana (2251 CIT) and active in the NPI registry since May 2007.

NPPES Registry Identity

NPI1184825705
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameMR. MARK SHANE ANDERSONCredential: RAC, CCDP, CCGC
Location Address4105 KIRKMAN STLake Charles, LA 70607-4603
Mailing Address811 Fall StLake Charles, LA 70601-8659 · (337) 433-4475
Phone(337) 475-8738
Fax(337) 475-8054
Sole ProprietorNo
Enumeration DateMay 30, 2007
Last NPPES UpdateSeptember 23, 2011
✔ NPI 1184825705 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in LA · 2251 CIT
4105 KIRKMAN ST, Lake Charles, LA 70607
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Other Identifiers 1

Medicare ID-Type Unspecified5CV41LA · Lcadc

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DEANNA TURNER CAC
Counselor (Addiction (Substance Use Disorder))
4105 KIRKMAN ST
LAKE CHARLES, LA 70607
Calcasieu Parish (337) 475-8022
TANYA JANUARY RN
Registered Nurse
4105 KIRKMAN ST
LAKE CHARLES, LA 70607
Calcasieu Parish (337) 475-8022
C. ELISKA WAGNON
Counselor (Mental Health)
4105 KIRKMAN ST
LAKE CHARLES, LA 70607
Calcasieu Parish (337) 475-8022
MRS. AMY ROSE FELICE RAC
Counselor (Addiction (Substance Use Disorder))
4105 KIRKMAN ST
LAKE CHARLES, LA 70607
Calcasieu Parish (337) 475-8022
CAROLYN ANN DAVIS LPC, NCC, CCDP-D
Counselor (Professional)
4105 KIRKMAN ST
LAKE CHARLES, LA 70607
Calcasieu Parish (337) 475-8022
DIANE GAIL FRUGE RAC
Counselor (Addiction (Substance Use Disorder))
4105 KIRKMAN ST
LAKE CHARLES, LA 70607
Calcasieu Parish (337) 475-2088
MR. JEROME HOLLAND G.S.W.
Social Worker (Clinical)
4105 KIRKMAN ST
LAKE CHARLES, LA 70607
Calcasieu Parish (337) 475-8022
MISS ALBERTHA J ADCOCK CAC
Counselor (Addiction (Substance Use Disorder))
4105 KIRKMAN ST
LAKE CHARLES, LA 70607
Calcasieu Parish (337) 475-8022

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mark Anderson's NPI number?

The NPI number for Mark Anderson is 1184825705. It was assigned to this individual provider in the NPPES registry on May 30, 2007.

Where is Mark Anderson located?

Mark Anderson practices at 4105 Kirkman St, Lake Charles, LA 70607. The listed phone number is (337) 475-8738.

What is Mark Anderson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Mark Anderson was last updated on September 23, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.