BILLY M ANDERSON (LICSW, LADC, LPCC) – Social Worker, NPI 1033286414

BILLY M ANDERSON (LICSW, LADC, LPCC) is a healthcare provider. based in Minneapolis, Minnesota. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LICSW, LADC, LPCC. They hold a License No. 12688 (MN). The NPI Number for BILLY M ANDERSON (LICSW, LADC, LPCC) is 1033286414

Main info

Male
13 Years Of Experience
Accepts Medicare Assignment
Name
BILLY M ANDERSON (LICSW, LADC, LPCC)
NPI
1033286414
Phone
(612) 302-3140
Address
2100 Plymouth Ave N Ste 245
Enumeration Date
29 November 2006
Last Update Date
30 January 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3202597706
Graduation Year
2013 (13 years ago)
PAC ID
1052720166
Professional Enrollment ID
I20210430001892
Address ID
MN563034202SA2700XNXXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience80
Completeness85
Years active:19State licenses:3Digital endpointsOther names

2,310 CLINICAL SOCIAL WORKER in MN

Provider Addresses for BILLY M ANDERSON (LICSW, LADC, LPCC)

  • 2100 Plymouth Ave N Ste 245

    Minneapolis, MN 554113675

    Phone: (612) 302-3140

    Type: Location

  • 22, Wilson Avenue Northeast, St. Cloud, Benton County, Minnesota, 56304, United States

    209

    SAINT CLOUD, MN 563040440

    Phone: (320) 259-7706

    Fax: (320) 251-4590

    Type: Mailing

  • 1501 XERXES AVE N

    MINNEAPOLIS, MN 554112851

    Phone: (763) 522-0100

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-04-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20210430001892IClinical Social WorkerMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55411)

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Reviews

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Frequently asked questions

Can I verify BILLY M ANDERSON (LICSW, LADC, LPCC) with an NPI only?
You can start verification with NPI 1033286414 for BILLY M ANDERSON (LICSW, LADC, LPCC), then check state licensing separately.
Does CMS list BILLY M ANDERSON (LICSW, LADC, LPCC) as active?
Yes — BILLY M ANDERSON (LICSW, LADC, LPCC) is active in the NPI listing used on this page.
What healthcare role does BILLY M ANDERSON (LICSW, LADC, LPCC) hold?
Scheduling teams often label BILLY M ANDERSON (LICSW, LADC, LPCC) under Social Worker. Clinical services aligned with this taxonomy classification.
What area does BILLY M ANDERSON (LICSW, LADC, LPCC) serve?
BILLY M ANDERSON (LICSW, LADC, LPCC)'s listing highlights Minneapolis, Minnesota; more addresses can appear in NPPES.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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