Anthony Aadolphus Lord I, is a
Peer Specialist based in Novato, California. Anthony Aadolphus Lord I is licensed to practice in California (license number MPSS-CAZSPQ) and his current practice location is
1140 Elm Dr Apt 3, Novato, California. He can be reached at his office (for appointments etc.) via phone at
(415) 320-2489.
NPI number for Anthony Aadolphus Lord I is 1376070490 and his current mailing address is 1140 Elm Dr Apt 3, Novato, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1376070490.
Healthcare Provider's Profile
| Full Name | Anthony Aadolphus Lord I |
|---|
| Gender | Male |
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| Speciality | Peer Specialist |
|---|
| Location | 1140 Elm Dr Apt 3, Novato, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1376070490
- Provider Enumeration Date: 05/19/2017
- Last Update Date: 08/04/2025
Medical Identifiers
Medical identifiers for Anthony Aadolphus Lord I such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1376070490 | NPI | - | NPPES |
| N5836204 | Medicaid | CA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 175T00000X | Peer Specialist | MPSS-CAZSPQ (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Anthony Aadolphus Lord I is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Anthony Aadolphus Lord I,
1140 Elm Dr Apt 3,
Novato, CA 94945-3133
Ph: (415) 320-2489 | Anthony Aadolphus Lord I,
1140 Elm Dr Apt 3,
Novato, CA 94945-3133
Ph: (415) 320-2489 |
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