Provider Demographics
NPI:1902488968
Name:ANDRUSKY, JOLYNN DIANE (LSW)
Entity Type:Individual
Prefix:MRS
First Name:JOLYNN
Middle Name:DIANE
Last Name:ANDRUSKY
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3772 TAMARACK DR
Mailing Address - Street 2:
Mailing Address - City:SHARPSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16150-9316
Mailing Address - Country:US
Mailing Address - Phone:724-813-7618
Mailing Address - Fax:
Practice Address - Street 1:130 W NORTH ST
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16101-3906
Practice Address - Country:US
Practice Address - Phone:724-510-3323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-28
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker