Conrad Ashton Anderson, L.C.S.W., PH.D.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L.C.S.W. C#3822 Issued in MS

Practice address

1636 Popps Ferry Rd
Suite 215
Biloxi, MS 39532-2217

Phone

(228) 365-3552

Fax

(228) 392-9743

NPI assigned

Sep 29, 2006

Last updated

Feb 15, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Psychological and Life Skills Associates, P.C.

  • Psychologist
  • Woodbridge, VA
  • NPI 1619066727
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392422400000",
    "number": "1255423695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "739 BUDDELIA CV",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395324118",
            "telephone_number": "228-365-3552",
            "fax_number": "228-392-9743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1636 POPPS FERRY RD",
            "address_2": "SUITE 215",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395322217",
            "telephone_number": "228-365-3552",
            "fax_number": "228-392-9743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "CONRAD",
        "middle_name": "ASHTON",
        "name_prefix": "Dr.",
        "credential": "L.C.S.W., PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2014-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "L.C.S.W. C#3822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MS MEDICAID PROVIDER # 06656046",
            "identifier": "06656046",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "030389866",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "302I803223",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amedisys Mississippi, LLC (Adoration Home Health)
• Babak Amrollahie
• Anchor Coast Direct Care
• Heather N Andersen, LMSW
• Brandon C. Anderson, DMD
• Ellie Rebecca Anderson
• Ryan Anderson, DO
• Andrew S Art of Pharmacy PLLC (Solutions the Pharmacy Doctor)
• Anesthesia & Pain Control Services, Inc.
• Anesthesia Solutions of Biloxi LLC

• Clinical Social Worker in Biloxi, MS
• Providers in Biloxi, MS by specialty
• Clinical Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.