Provider Demographics
NPI:1255910998
Name:BOZZELLI, ANDREW FRANZ (LCSW)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:FRANZ
Last Name:BOZZELLI
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:999 ADAMS BLVD STE 107
Mailing Address - Street 2:
Mailing Address - City:BOULDER CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89005-2245
Mailing Address - Country:US
Mailing Address - Phone:702-294-5757
Mailing Address - Fax:
Practice Address - Street 1:999 ADAMS BLVD STE 107
Practice Address - Street 2:
Practice Address - City:BOULDER CITY
Practice Address - State:NV
Practice Address - Zip Code:89005-2245
Practice Address - Country:US
Practice Address - Phone:702-294-5757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-07
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9121-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical