Provider Demographics
NPI:1295219392
Name:ANDREW, SCOTT JOSEPH (LICSW)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:JOSEPH
Last Name:ANDREW
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 FERN ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01062-1309
Mailing Address - Country:US
Mailing Address - Phone:413-535-6368
Mailing Address - Fax:
Practice Address - Street 1:100 BRIDGE RD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:MA
Practice Address - Zip Code:01062-4504
Practice Address - Country:US
Practice Address - Phone:413-587-4920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-24
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1113721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical