Provider Demographics
NPI:1184865529
Name:ANDREWS, TIM EARLE (LICENSED INTERN MSW)
Entity type:Individual
Prefix:
First Name:TIM
Middle Name:EARLE
Last Name:ANDREWS
Suffix:
Gender:M
Credentials:LICENSED INTERN MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1840 NE 34TH CT
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33306-1022
Mailing Address - Country:US
Mailing Address - Phone:954-294-3114
Mailing Address - Fax:
Practice Address - Street 1:1840 NE 34TH CT
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33306-1022
Practice Address - Country:US
Practice Address - Phone:954-294-3114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-16
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW45241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical