Provider Demographics
NPI:1568084077
Name:ANDRZEJEWSKI, CHARLES PATRICK
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:PATRICK
Last Name:ANDRZEJEWSKI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25700 SCIENCE PARK DR
Mailing Address - Street 2:280
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-7137
Mailing Address - Country:US
Mailing Address - Phone:216-772-3642
Mailing Address - Fax:
Practice Address - Street 1:25700 SCIENCE PARK DR
Practice Address - Street 2:280
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-7137
Practice Address - Country:US
Practice Address - Phone:216-772-3642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-07
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.24061131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical