Provider Demographics
NPI:1770218737
Name:ANDREA SPARROW, LLC
Entity Type:Organization
Organization Name:ANDREA SPARROW, LLC
Other - Org Name:ANDREA SPARROW, LCSW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:K
Authorized Official - Last Name:SPARROW
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:502-617-0937
Mailing Address - Street 1:1626 S BENSON RD
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40601-9747
Mailing Address - Country:US
Mailing Address - Phone:502-385-1079
Mailing Address - Fax:
Practice Address - Street 1:130 KINGS DAUGHTERS DR
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-4248
Practice Address - Country:US
Practice Address - Phone:502-617-0937
Practice Address - Fax:502-223-7491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-22
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health