Matthew Gordon Anderson, L.C.S.W.
Social Worker in Vicksburg, MS. Individual provider (NPI-1).
NPI number1760822860
StatusActive
Last updated in NPPESJul 9, 2019
Details
- NPI
- 1760822860
- Entity type
- Individual (NPI-1)
- Name
- Mr. Matthew Gordon Anderson
- Credential
- L.C.S.W.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jul 3, 2013
- Last updated
- Jul 9, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - CLINICAL SOCIAL WORKER
- Can order and refer
- Part B Yes · DME Yes · Home health No · Power mobility No · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 104100000X | Social Worker | M7209 | MS | Yes |
Practice location
1905b Mission 66Vicksburg, MS 39180-3711
Phone 601-724-9201
Mailing address
Po Box 820143Vicksburg, MS 39182-0143
Phone 601-326-3783 · Fax 601-326-3766
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 9 Social Worker providers in Vicksburg · All 1,002 providers in Vicksburg
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