Provider Demographics
NPI:1174023204
Name:SCALES, ANDREA MENDELL (MSW U/S)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:MENDELL
Last Name:SCALES
Suffix:
Gender:F
Credentials:MSW U/S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2250 N AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:OK
Mailing Address - Zip Code:73096-3351
Mailing Address - Country:US
Mailing Address - Phone:580-375-6367
Mailing Address - Fax:580-323-5635
Practice Address - Street 1:2250 N AIRPORT RD
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:OK
Practice Address - Zip Code:73096-3351
Practice Address - Country:US
Practice Address - Phone:580-375-6367
Practice Address - Fax:580-323-5635
Is Sole Proprietor?:No
Enumeration Date:2018-02-15
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK67521041C0700X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical