Provider Demographics
NPI:1760053896
Name:SCOTT-MAGUIRE, ANDREA LORNE (MSSW)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:LORNE
Last Name:SCOTT-MAGUIRE
Suffix:
Gender:F
Credentials:MSSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 OLD GREAT NECK RD STE 203
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-3358
Mailing Address - Country:US
Mailing Address - Phone:757-520-1312
Mailing Address - Fax:
Practice Address - Street 1:509 OLD GREAT NECK RD STE 203
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-3358
Practice Address - Country:US
Practice Address - Phone:757-520-1312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-09
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09060130011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical