James Andersen, LCSW
Individual provider Active NPI Clinical Social Worker · West Hartford, CT
NPI 1275764649 · NPPES record last updated May 21, 2019
Key facts
- NPI
- 1275764649
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 007590 (CT)
- Practice address
- 15 Nesbit Ave
# 2
West Hartford, CT 06119-2010 - Phone
- (860) 646-3888
- Fax
- (860) 645-4132
- NPI assigned
- Aug 4, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
128 Garden St
Farmington, CT 06032-2254
Phone (860) 952-9512
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120726000393 | CT | Practitioner - Clinical Social Worker | 8820254436 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007590 | CT | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Health Resources, Inc. | Current |
Accepting new patients | |
| Community Health Resources, Inc. | Current |
Accepting new patients |
Locations
153 Hazard Ave
Enfield, CT 06082
Phone (860) 253-5020
444 Center St
Manchester, CT 06040
Phone (860) 646-3888
2 Waterside Xing
Ste 401
Windsor, CT 06095
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 007590 | CT | Yes |
Addresses
Primary practice location
15 Nesbit Ave
# 2
West Hartford, CT 06119-2010
Mailing address
15 Nesbit Ave
# 2
West Hartford, CT 06119-2010
Phone (860) 731-5522
Other providers in West Hartford, CT
- American Relief LLC
- American School for the Deaf
- Ample Urgent and Primary Care LLC
- Wei An
- Anb-Ptsma Holdings, Inc.
- Elizabeth Catherine Anderson
- Susan A Anderson
- Andrea Bayley, LLC
- Jenna E Angello
- Ann Osoba LPC LLC
All providers in West Hartford, CT · Clinical Social Worker in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 21, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.