Provider Demographics
NPI:1295378859
Name:RULE, ANDREA TERESE (LCSW)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:TERESE
Last Name:RULE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5835 BOHLEYSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:MILLSTADT
Mailing Address - State:IL
Mailing Address - Zip Code:62260-2323
Mailing Address - Country:US
Mailing Address - Phone:618-920-9877
Mailing Address - Fax:
Practice Address - Street 1:210 W SAND BANK RD STE 14
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:IL
Practice Address - Zip Code:62236-1044
Practice Address - Country:US
Practice Address - Phone:618-920-9877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-25
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0198201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical