MRS. AUDREY ANDERSON LAC LCADC
NPI 1760173264
Counselor - Addiction (Substance Use Disorder) in Newark, NJ

Q: What is Audrey Anderson's NPI number?

The NPI number for Audrey Anderson is 1760173264. It was assigned to this individual provider in the NPPES registry on May 16, 2023.

Q: What is Audrey Anderson's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Audrey Anderson was last updated on May 16, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since May 16, 2023PECOS Enrolled

47 MILLER STREET 2ND FLOOR, NEWARK, NJ 07114(973) 596-4190(973) 639-6583 Get Directions Write a Review

NPPES record last updated: May 16, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Mrs. Audrey Anderson Lac Lcadc NPPES

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

MRS. AUDREY ANDERSON LAC LCADC (NPI 1760173264) is an individual addiction (substance use disorder) provider in Newark, New Jersey, licensed in New Jersey (37LC00334900) and active in the NPI registry since May 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1760173264

Entity TypeIndividualFemale

Primary Taxonomy101YA0400X

Provider Legal NameMRS. AUDREY ANDERSONCredential: LAC LCADC

Location Address47 MILLER STREET 2ND FLOORNewark, NJ 07114-1750

Mailing Address590 North 7th StreetNewark, NJ 07107 · (800) 227-7705

Phone(973) 596-4190

Fax(973) 639-6583

Sole ProprietorYes

Enumeration DateMay 16, 2023

NPPES CertifiedMay 16, 2023

✔ NPI 1760173264 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers

Taxonomy Code101YA0400X

License✔ Licensed in NJ · 37LC00334900

Also ListedCounselorTaxonomy 101Y00000X · License 37AC00551600 (NJ)

47 MILLER STREET 2ND FLOOR, Newark, NJ 07114

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Audrey Anderson Lac Lcadc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Audrey Anderson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mount Carmel Guild Behavioral Health System

Same address

Mental Health (Including Community Mental Health Center)

47 MILLER ST
Newark, NJ 07114

Reassigned Medicare billing, New Jersey enrollment
Medicare enrollment name: Mount Carmel Guild Behavioral Health
17 clinicians in this Medicare group

NPI 1174854749 (973) 639-4300

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Audrey Anderson's NPI number?

The NPI number for Audrey Anderson is 1760173264. It was assigned to this individual provider in the NPPES registry on May 16, 2023.

Where is Audrey Anderson located?

Audrey Anderson practices at 47 Miller Street 2nd Floor, Newark, NJ 07114. The listed phone number is (973) 596-4190.

What is Audrey Anderson's specialty?

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

Is Audrey Anderson enrolled in Medicare?

Yes. Audrey Anderson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Audrey Anderson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Audrey Anderson reassigns Medicare benefits to Mount Carmel Guild Behavioral Health System (Newark, NJ). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Audrey Anderson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Audrey Anderson was last updated on May 16, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.