Provider Demographics
NPI:1194838508
Name:ANDRE, MARSHA (MSW, LCSW-C)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:
Last Name:ANDRE
Suffix:
Gender:F
Credentials:MSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14230 FORSYTHE ROAD
Mailing Address - Street 2:
Mailing Address - City:SYKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21784
Mailing Address - Country:US
Mailing Address - Phone:443-812-5976
Mailing Address - Fax:301-989-1640
Practice Address - Street 1:14230 FORSYTHE ROAD
Practice Address - Street 2:
Practice Address - City:SYKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21784
Practice Address - Country:US
Practice Address - Phone:443-812-5976
Practice Address - Fax:301-989-1640
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD125111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical