Provider Demographics
NPI:1952546525
Name:GRULER, ANDREW M (LISW-CP)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:M
Last Name:GRULER
Suffix:
Gender:M
Credentials:LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2123 OLD SPARTANBURG RD # 167
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-2704
Mailing Address - Country:US
Mailing Address - Phone:864-236-7335
Mailing Address - Fax:864-244-5926
Practice Address - Street 1:7C CLEVELAND CT
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-2414
Practice Address - Country:US
Practice Address - Phone:864-236-7335
Practice Address - Fax:864-244-5926
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-10
Last Update Date:2008-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC61991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical