Provider Demographics
NPI:1396183331
Name:ANDREWS, CHERYL JON (LCSW)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:JON
Last Name:ANDREWS
Suffix:
Gender:F
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:PO BOX 906
Mailing Address - Street 2:
Mailing Address - City:TALLEVAST
Mailing Address - State:FL
Mailing Address - Zip Code:34270-0906
Mailing Address - Country:US
Mailing Address - Phone:941-807-0072
Mailing Address - Fax:
Practice Address - Street 1:3323 MEADOW RUN CIR
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34293-1417
Practice Address - Country:US
Practice Address - Phone:941-807-0072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-12
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL105991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical