Provider Demographics
NPI:1902513484
Name:DENNY, ANDREA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:
Last Name:DENNY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60352
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63160-0352
Mailing Address - Country:US
Mailing Address - Phone:314-362-1408
Mailing Address - Fax:314-747-8427
Practice Address - Street 1:4921 PARKVIEW PL
Practice Address - Street 2:DIV NEUROLOGY ADULT, STE 6C
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1032
Practice Address - Country:US
Practice Address - Phone:314-362-1408
Practice Address - Fax:314-747-8427
Is Sole Proprietor?:No
Enumeration Date:2022-11-03
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20220174161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO490118614Medicaid