Healthcare Provider Details

I. General information

NPI: 1841900305
Provider Name (Legal Business Name): ARTHUR JAMES ANDERSON LCSW, RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/24/2022
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

267 GRANT ST
BRIDGEPORT CT
06610-2805
US

IV. Provider business mailing address

494 NEWFIELD RD
TORRINGTON CT
06790-2807
US

V. Phone/Fax

Practice location:
  • Phone: 203-494-0499
  • Fax:
Mailing address:
  • Phone: 203-494-0499
  • Fax: 203-494-0499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number197887
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number13547
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number13547
License Number StateCT
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number11179
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: