Provider Demographics
NPI:1376140871
Name:ANDREWS, LIA M (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LIA
Middle Name:M
Last Name:ANDREWS
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:PO BOX 156
Mailing Address - Street 2:
Mailing Address - City:HOMELAND
Mailing Address - State:CA
Mailing Address - Zip Code:92548-0156
Mailing Address - Country:US
Mailing Address - Phone:323-304-1322
Mailing Address - Fax:
Practice Address - Street 1:21935 VAN BUREN ST # B-7
Practice Address - Street 2:
Practice Address - City:GRAND TERRACE
Practice Address - State:CA
Practice Address - Zip Code:92313-5652
Practice Address - Country:US
Practice Address - Phone:909-906-1023
Practice Address - Fax:909-906-1023
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-07
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA926421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical