Look up the most recent NPI and PECOS records

Lisa A Anderson

Social Worker

Behavioral Health & Social Service Providers

617 Riverside Ave, Burlington, VT 05401-1601

PECOS Enrollment

Based on the most recent information from CMS, provider Lisa A Anderson does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records today at 9:43 AM.

Profile Details

Provider ID
1487676466
Provider Type
Individual
Full Name
Anderson, Lisa A
Credential
LICSW

Gender
Female
Sole Proprietor
No
Enumeration Date
7/25/2006
Last Updated
9/18/2007

Contact Information

Practice Location

617 Riverside Ave, Burlington, VT 05401-1601

(802) 864-6309

(802) 860-4324

Mailing Location

617 Riverside Ave, Burlington, VT 05401-1601

(802) 864-6309

(802) 860-4324

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 089-0001063 Vermont

Provider Identifiers

ID	Description	Issuer
ID 1011314	Description Medicaid	Issuer Unlisted Vermont
ID 00069175	Description Other	Issuer BC/BS OF VT Vermont
ID 2288731	Description Other	Issuer CIGNA Vermont
ID 376827	Description Other	Issuer TRICARE Vermont
ID 594038	Description Other	Issuer VALUE OPTIONS Vermont

Lisa A Anderson

PECOS Enrollment

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