Provider Demographics
NPI:1194845941
Name:WALD, ANDREW LEONARD (LCSWC)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:LEONARD
Last Name:WALD
Suffix:
Gender:M
Credentials:LCSWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3110 BROOKLAWN TER
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-3942
Mailing Address - Country:US
Mailing Address - Phone:301-675-9980
Mailing Address - Fax:
Practice Address - Street 1:3110 BROOKLAWN TER STE 200
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-3942
Practice Address - Country:US
Practice Address - Phone:301-675-9980
Practice Address - Fax:301-657-2814
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD028641041C0700X
MD26841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD02864OtherSOCIAL WORK