Provider Demographics
NPI:1407016785
Name:ANDERSON, ELIZABETH ROSE (MSW, LICSW)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:ROSE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 PLEASANT ST STE 331
Mailing Address - Street 2:
Mailing Address - City:EASTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01027-2756
Mailing Address - Country:US
Mailing Address - Phone:413-247-4972
Mailing Address - Fax:
Practice Address - Street 1:116 PLEASANT ST STE 331
Practice Address - Street 2:
Practice Address - City:EASTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01027-2756
Practice Address - Country:US
Practice Address - Phone:413-247-4972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1161101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical