Provider Demographics
NPI:1225155765
Name:MORENOFF, ANDREA (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:
Last Name:MORENOFF
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9712 BARRISTER CT
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-1742
Mailing Address - Country:US
Mailing Address - Phone:301-530-5444
Mailing Address - Fax:301-897-4994
Practice Address - Street 1:5411 W CEDAR LN
Practice Address - Street 2:SUITE 207A
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-1516
Practice Address - Country:US
Practice Address - Phone:301-897-8990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD038341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD646-555Medicare ID - Type Unspecified