Provider Demographics
NPI:1194034769
Name:BERTELL, ANDREW (LCSW-C)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:BERTELL
Suffix:
Gender:
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:267 8TH ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-2037
Mailing Address - Country:US
Mailing Address - Phone:443-240-8275
Mailing Address - Fax:
Practice Address - Street 1:302 E HERSEY ST STE 10
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-1200
Practice Address - Country:US
Practice Address - Phone:443-240-8275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-30
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0158041041C0700X
MD195391041C0700X
ORL121081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical