Provider Demographics
NPI:1699974998
Name:GIFFORD, ANDREA MARIE (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:MARIE
Last Name:GIFFORD
Suffix:
Gender:F
Credentials:MSW, 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 395
Mailing Address - Street 2:
Mailing Address - City:CRESWELL
Mailing Address - State:OR
Mailing Address - Zip Code:97426-0395
Mailing Address - Country:US
Mailing Address - Phone:541-357-7234
Mailing Address - Fax:
Practice Address - Street 1:281 W OREGON AVE
Practice Address - Street 2:
Practice Address - City:CRESWELL
Practice Address - State:OR
Practice Address - Zip Code:97426-9605
Practice Address - Country:US
Practice Address - Phone:541-357-7234
Practice Address - Fax:541-216-4915
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-16
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical