Provider Demographics
NPI:1578914461
Name:ANNE T HARDERS, LCSW
Entity Type:Organization
Organization Name:ANNE T HARDERS, LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:TRUSLOW
Authorized Official - Last Name:HARDERS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:7819-132-4445
Mailing Address - Street 1:55 WINDRUSH LN
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:CT
Mailing Address - Zip Code:06232-1610
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:223 E CENTER ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-5248
Practice Address - Country:US
Practice Address - Phone:860-327-4844
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-22
Last Update Date:2016-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0068261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT106712016Medicare UPIN