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NPI Code Detail

MEDICARE: ANDREA LEE ABBOTT LCSW

MEDICARE: ANDREA LEE ABBOTT 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
1251S00000XCommunity/Behavioral Health Agency
21041C0700XClinical Social WorkerC101933NC

General Provider Information

NPI Number : 1790166395
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA LEE ABBOTT LCSW
Provider Business Mailing Address
First Line : 7489 ROCKFISH RD
Second Line :
City : RAEFORD
State : NC
Zip : 28376-6131
Country : US
Telephone Number : 727-798-7873
Fax Number : 833-260-0543
Provider Business Practice Location Address
First Line : 7489 ROCKFISH RD
Second Line :
City : RAEFORD
State : NC
Zip : 28376-6131
Country : US
Telephone Number : 727-798-7873
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2015
Last Update Date : 08/29/2022

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Directions to “ ANDREA LEE ABBOTT LCSW” Practice Location

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