Provider Demographics
NPI:1902530454
Name:SMITH-THOMPSON, ANDREA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:
Last Name:SMITH-THOMPSON
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 1:213 E MORELAND RD
Mailing Address - Street 2:
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-3524
Mailing Address - Country:US
Mailing Address - Phone:215-767-1606
Mailing Address - Fax:
Practice Address - Street 1:213 E MORELAND RD
Practice Address - Street 2:
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-3524
Practice Address - Country:US
Practice Address - Phone:215-767-1606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-11
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0228521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical