Provider Demographics
NPI:1548734155
Name:ANDREWS, JOLYN (LCSW 21345)
Entity Type:Individual
Prefix:
First Name:JOLYN
Middle Name:
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:LCSW 21345
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 S SANDSTONE ST # NA
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-1306
Mailing Address - Country:US
Mailing Address - Phone:480-436-0813
Mailing Address - Fax:
Practice Address - Street 1:70 S SANDSTONE ST
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-1306
Practice Address - Country:US
Practice Address - Phone:480-436-0813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-16
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ213451041C0700X
AZ17361104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker