Provider Demographics
NPI:1659708774
Name:ANDREWS, LISA (LGSW)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3625 ROBIN AIR CT
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-7203
Mailing Address - Country:US
Mailing Address - Phone:443-618-5846
Mailing Address - Fax:
Practice Address - Street 1:2528 MOUNTAIN ROAD SUITE 204
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-7203
Practice Address - Country:US
Practice Address - Phone:410-255-4475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD7631311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical