Individual provider · NPI-1

Andrea Age, LCSWA

Social Worker, Clinical · Concord, NC

NPI number1699532937
StatusActive
Last updated in NPPESApr 23, 2024

Details

NPI
1699532937
Entity type
Individual (NPI-1)
Name
Andrea Age
Credential
LCSWA
Sex
Female
Sole proprietor
Yes
Enumeration date
Mar 4, 2024
Certification date
Apr 16, 2024
Last updated
Apr 23, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, ClinicalP018904NCYes

Practice location

280 Executive Park Dr Ste 100
Concord, NC 28025-1838

Phone 704-237-4240

Mailing address

280 Executive Park Dr Ste 100
Concord, NC 28025-1838

Phone 704-526-8173

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