Provider Demographics
NPI:1457913535
Name:ANDERSON, ELIZABETH CATHERINE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:CATHERINE
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 1:1 FOREST HILLS DR
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06117-1112
Mailing Address - Country:US
Mailing Address - Phone:860-231-8886
Mailing Address - Fax:
Practice Address - Street 1:1100 NEW BRITAIN AVE FL 2
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06110-2427
Practice Address - Country:US
Practice Address - Phone:860-245-8887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-28
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0081111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical