Sue Anderson, LCSW

Key facts

NPI

1205937844

Entity type

Individual (NPI type 1)

Primary specialty

Clinical Social Worker 1041C0700X

License

004121 (CT)

Practice address

24 McKinley St
Norwalk, CT 06853-1419

Phone

(203) 831-0748

NPI assigned

Sep 26, 2006

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 28, 2010.

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277683200000",
    "number": "1205937844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 MCKINLEY ST",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068531419",
            "telephone_number": "203-831-0748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 MCKINLEY ST",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068531419",
            "telephone_number": "203-831-0748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "SUE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2010-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "004121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004172920",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004172912",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Israel Wheeler Andola, P.A.
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• Janet Smith Andrews, M.D.
• Julianne Andrews, BCBA

All providers in Norwalk, CT · Clinical Social Worker in Connecticut