Provider Demographics
NPI:1396048161
Name:WINTERS, ANDREW MADISON (LISWS)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:MADISON
Last Name:WINTERS
Suffix:
Gender:M
Credentials:LISWS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:KY
Mailing Address - Zip Code:41071-4577
Mailing Address - Country:US
Mailing Address - Phone:513-675-3833
Mailing Address - Fax:513-651-2310
Practice Address - Street 1:1026 DELTA AVE STE A
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45208-3164
Practice Address - Country:US
Practice Address - Phone:513-675-3833
Practice Address - Fax:513-651-2310
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-16
Last Update Date:2010-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.0009843-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical