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NPI 1447654736

NPI 1447654736 : ANNA ANDRICH LCSW : NEW HAVEN, CT

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General NPI Number Information
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    NPI Number           |    1447654736
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    Entity Type          |    Individual 
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    Provider Name        |    ANNA ANDRICH LCSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/15/2014
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    Last Update Date     |    07/22/2019
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Provider Practice Location Address
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    Address Line         |    20 YORK ST 
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    City                 |    NEW HAVEN
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    State                |    CT
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    Zip                  |    06510-3220
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    Country              |    US
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    Telephone            |    203-430-0011
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    280 N ELM ST 
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    City                 |    WALLINGFORD
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    State                |    CT
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    Zip                  |    06492-3232
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    Country              |    US
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    Telephone            |    203-430-0011
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    104100000X
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    Taxonomy Name        |    Social Worker
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    10382
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    License Number State |    CT
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