Healthcare Provider Details

I. General information

NPI: 1417872193
Provider Name (Legal Business Name): ANDREA DANIELLE BARTOLI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 EAST BLVD
CHARLOTTE NC
28203-5203
US

IV. Provider business mailing address

901 EAST BLVD
CHARLOTTE NC
28203-5203
US

V. Phone/Fax

Practice location:
  • Phone: 704-335-2769
  • Fax:
Mailing address:
  • Phone: 704-335-2769
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP023898
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: