Provider Demographics
NPI:1467007203
Name:ANDREWS, JACQUELYN (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:JACQUELYN
Middle Name:
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:495 WEST ST UNIT 1C
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-3379
Mailing Address - Country:US
Mailing Address - Phone:413-426-1793
Mailing Address - Fax:
Practice Address - Street 1:495 WEST ST UNIT 1C
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-3379
Practice Address - Country:US
Practice Address - Phone:413-426-1793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-08
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1202041041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker