Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Mark Shane Anderson, RAC, CCDP, CCGC

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1184825705

Mr. Mark Shane Anderson, RAC, CCDP, CCGC is an Addiction (Substance Use Disorder) Counselor in Lake Charles, Louisiana. Licensed in Louisiana. Registered with an NPI since 2007.

Licensed in
LA
In the registry since
2007

Practice location Address checks out

4105 Kirkman St
Lake Charles, LA 70607-4603
Phone: (337) 475-8738
Fax: (337) 475-8054
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence 2251 CIT (LA)

Record details

NPI number1184825705
Entity typeIndividual (Type 1)
GenderMale
Credentials RAC , CCDP , CCGC
Sole proprietorNo
NPI enumeratedMay 30, 2007
Last updated in NPPESSeptember 23, 2011

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