Provider Demographics
NPI:1922001171
Name:ANDERSON, JOY A (LCSW)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:A
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-3554
Mailing Address - Country:US
Mailing Address - Phone:812-282-1888
Mailing Address - Fax:812-285-8392
Practice Address - Street 1:510 SPRING ST
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-3554
Practice Address - Country:US
Practice Address - Phone:812-282-1888
Practice Address - Fax:812-285-8392
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2009-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34000547104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200319860AMedicaid
KY2444451000OtherPASSPORT GROUP
KY500026068OtherMEDICARE RAILROAD
KYCK2274OtherRAILROAD MEDICARE GROUP
IN100386460OtherINDIANA MEDICAID GROUP
IN160780OtherMEDICARE GROUP
IN160860OtherMEDICARE GROUP
KY2772085000OtherPASSPORT ADVANTAGE
5980100OtherMAGELLAN MIS
IN800012513OtherMEDICARE RAILROAD
INCG3623OtherMEDICARE RAILROAD GROUP
000000056294OtherANTHEM GROUP #
KY8200064700Medicaid
000000194070OtherANTHEM
50704000OtherMAGELLAN GROUP MIS
INCG3623OtherMEDICARE RAILROAD GROUP