Provider Demographics
NPI:1770824690
Name:ANDRUS, CAROL ANN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:ANN
Last Name:ANDRUS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BLDG 90643
Mailing Address - Street 2:
Mailing Address - City:HURLBURT FIELD AFB
Mailing Address - State:FL
Mailing Address - Zip Code:32544
Mailing Address - Country:US
Mailing Address - Phone:850-884-2510
Mailing Address - Fax:
Practice Address - Street 1:BLDG 90643
Practice Address - Street 2:
Practice Address - City:HURLBURT FIELD AFB
Practice Address - State:FL
Practice Address - Zip Code:32544
Practice Address - Country:US
Practice Address - Phone:850-884-2510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-04
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 81441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical