Active NPI
Elizabeth Rose Anderson, MSW, LICSW
- Clinical Social Worker
- Easthampton, MA
National Provider Identifier
1407016785
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 116110
- Practice address
- 116 Pleasant St Ste 331
Easthampton, MA 01027-2756 - Phone
- (413) 247-4972
- NPI assigned
- Jun 11, 2008
- Last updated
- Nov 22, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 116110 | MA | Primary |
Addresses
Primary practice location
116 Pleasant St Ste 331
Easthampton, MA 01027-2756
Mailing address
15 East St # 2
Easthampton, MA 01027-1209
Phone (413) 247-4972
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 9, 2022 through Mar 9, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 116110 | MA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732233600000",
"number": "1407016785",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 EAST ST # 2",
"city": "EASTHAMPTON",
"state": "MA",
"postal_code": "010271209",
"telephone_number": "413-247-4972",
"fax_number": "617-380-4578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "116 PLEASANT ST STE 331",
"city": "EASTHAMPTON",
"state": "MA",
"postal_code": "010272756",
"telephone_number": "413-247-4972"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "ELIZABETH",
"middle_name": "ROSE",
"name_prefix": "Ms.",
"credential": "MSW, LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-11",
"last_updated": "2024-11-22",
"certification_date": "2024-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "116110",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Easthampton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.