Provider Demographics
NPI:1770841488
Name:ADERTON, ANDREA HOPE (LMSW)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:HOPE
Last Name:ADERTON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 N IRONWOOD
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:MO
Mailing Address - Zip Code:64485
Mailing Address - Country:US
Mailing Address - Phone:816-324-5582
Mailing Address - Fax:
Practice Address - Street 1:206 N IRONWOOD ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:MO
Practice Address - Zip Code:64485-9469
Practice Address - Country:US
Practice Address - Phone:816-324-5582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-01
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011034616104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker