Individual provider · NPI-1

Bernetta A Andrewin, LCSW

Social Worker, Clinical · Springfield, IL

NPI number1033736707
StatusActive
Last updated in NPPESJul 1, 2020

Details

NPI
1033736707
Entity type
Individual (NPI-1)
Name
Ms. Bernetta A Andrewin
Credential
LCSW
Sex
Female
Sole proprietor
Yes
Enumeration date
Jun 29, 2020
Certification date
Jul 1, 2020
Last updated
Jul 1, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, Clinical149.020822ILYes

Practice location

4481 Ash Grove Dr Ste A-D
Springfield, IL 62711-6358

Phone 217-717-4733 · Fax 217-679-5981

Mailing address

317 E Kimble St
Springfield, IL 62703-4626

Phone 773-993-4518

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