Healthcare Provider Details

I. General information

NPI: 1801159108
Provider Name (Legal Business Name): ANDREW SONE LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2012
Last Update Date: 06/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

432 BRIDGE ST
SPRING CITY PA
19475-1306
US

IV. Provider business mailing address

432 BRIDGE ST
SPRING CITY PA
19475-1306
US

V. Phone/Fax

Practice location:
  • Phone: 484-903-0392
  • Fax:
Mailing address:
  • Phone: 484-903-0392
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW017319
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW10855
License Number StateFL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: