MEDICARE: ANDREA POIST BIRD MSW,LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	SW25378	FL

General Provider Information

NPI Number	:	1700155512
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA POIST BIRD MSW,LCSW

Provider Business Mailing Address
First Line	:	425 COMMERCIAL CT STE C
Second Line	:
City	:	VENICE
State	:	FL
Zip	:	34292-1642
Country	:	US
Telephone Number	:	941-244-4377
Fax Number	:	941-445-4186

Provider Business Practice Location Address
First Line	:	425 COMMERCIAL CT STE C
Second Line	:
City	:	VENICE
State	:	FL
Zip	:	34292-1642
Country	:	US
Telephone Number	:	941-244-4377
Fax Number	:	941-445-4186

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2011
Last Update Date	:	05/20/2026

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