Provider Demographics
NPI:1083848519
Name:FELL, ANDREA HENNUM (MSW)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:HENNUM
Last Name:FELL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:HENNUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4421 W 234TH ST
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4425
Mailing Address - Country:US
Mailing Address - Phone:310-378-6111
Mailing Address - Fax:
Practice Address - Street 1:4421 W 234TH ST
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4425
Practice Address - Country:US
Practice Address - Phone:310-378-6111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-12
Last Update Date:2013-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker