Provider Demographics
NPI:1609990977
Name:WOODWARD, ANDREA JANICE (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:JANICE
Last Name:WOODWARD
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1734 E 63RD ST
Mailing Address - Street 2:STE. 410
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64110-3543
Mailing Address - Country:US
Mailing Address - Phone:816-523-6990
Mailing Address - Fax:816-523-7071
Practice Address - Street 1:1734 E 63RD ST
Practice Address - Street 2:STE. 410
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64110-3543
Practice Address - Country:US
Practice Address - Phone:816-523-6990
Practice Address - Fax:816-523-7071
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0052291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical