Healthcare Provider Details

I. General information

NPI: 1821228537
Provider Name (Legal Business Name): ANDREA ROUNTREE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2009
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 PAOLI PLZ STE E
PAOLI PA
19301-1367
US

IV. Provider business mailing address

41 PAOLI PLZ STE E
PAOLI PA
19301-1367
US

V. Phone/Fax

Practice location:
  • Phone: 484-323-6286
  • Fax:
Mailing address:
  • Phone: 484-323-6286
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberCW017664
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: