| James Andersen Ma Lcsw Llc | |
|
15 Nesbit Ave #2 West Hartford CT 06119-2010 | |
| (860) 952-9512 | |
| Not Available |
| Full Name | James Andersen Ma Lcsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 15 Nesbit Ave, West Hartford, Connecticut |
| Authorized Official Name and Position | James Andersen (OWNER) |
| Authorized Official Contact | 8609529512 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| James Andersen Ma Lcsw Llc 15 Nesbit Ave #2 West Hartford CT 06119-2010 Ph: (860) 952-9512 | James Andersen Ma Lcsw Llc 15 Nesbit Ave #2 West Hartford CT 06119-2010 Ph: (860) 952-9512 |
| NPI Number | 1689114381 |
|---|---|
| Provider Enumeration Date | 02/28/2017 |
| Last Update Date | 06/10/2019 |
| Medicare PECOS PAC ID | 7012240815 |
|---|---|
| Medicare Enrollment ID | O20190611000744 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689114381 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 007590 (Connecticut) | Primary |
| Provider Name | James Andersen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275764649 PECOS PAC ID: 8820254436 Enrollment ID: I20120726000393 |
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