Provider Demographics
NPI:1831390244
Name:SOARES, ANDREA (LISW-S)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:SOARES
Suffix:
Gender:
Credentials:LISW-S
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:L SOARES
Other - Last Name:OMERZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW-S
Mailing Address - Street 1:18660 BAGLEY RD STE 404
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44130-3483
Mailing Address - Country:US
Mailing Address - Phone:440-234-8746
Mailing Address - Fax:440-234-8748
Practice Address - Street 1:18660 BAGLEY RD STE 404
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44130-3483
Practice Address - Country:US
Practice Address - Phone:440-234-8746
Practice Address - Fax:440-234-8748
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI91411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical