Active NPI
Joan M Anderson, LPN CADC CCS
- Counselor
- Middletown, CT
National Provider Identifier
1376670604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 000061
- Practice address
- 1250 Silver St
Middletown, CT 06457-3946 - Phone
- (860) 852-1037
- NPI assigned
- Feb 27, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 019526 | CT | |
| Counselor | 101Y00000X | 000061 | CT | Primary |
Addresses
Primary practice location
1250 Silver St
Middletown, CT 06457-3946
Mailing address
1250 Silver St
Middletown, CT 06457-3946
Phone (860) 852-1037
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019526 | CT | MD | Counselor |
| 000061 | CT | MD | Advanced Practice Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376670604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1250 SILVER ST",
"city": "MIDDLETOWN",
"state": "CT",
"postal_code": "064573946",
"telephone_number": "860-852-1037"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1250 SILVER ST",
"city": "MIDDLETOWN",
"state": "CT",
"postal_code": "064573946",
"telephone_number": "860-852-1037"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "JOAN",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "LPN CADC CCS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "CT",
"license": "019526",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "CT",
"license": "000061",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middletown, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.