Individual
LISA A ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
617 RIVERSIDE AVE, BURLINGTON, VT 05401-1601
(802) 864-6309
(802) 860-4324
Mailing address
617 RIVERSIDE AVE, BURLINGTON, VT 05401-1601
(802) 864-6309
(802) 860-4324
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
089-0001063
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00069175
BC/BS OF VT
VT
05
—
1011314
—
VT
01
—
2288731
CIGNA
VT
01
—
376827
TRICARE
VT
01
—
594038
VALUE OPTIONS
VT
Enumeration date
07/25/2006
Last updated
09/18/2007
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