Provider Demographics
NPI:1548030166
Name:SLUSSER, ANDI AMERY (ACSW)
Entity type:Individual
Prefix:
First Name:ANDI
Middle Name:AMERY
Last Name:SLUSSER
Suffix:
Gender:F
Credentials:ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13306 GARCIA ST
Mailing Address - Street 2:
Mailing Address - City:QUANTICO
Mailing Address - State:VA
Mailing Address - Zip Code:22134-4215
Mailing Address - Country:US
Mailing Address - Phone:570-764-2049
Mailing Address - Fax:
Practice Address - Street 1:27349 JEFFERSON AVE STE 111
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-5610
Practice Address - Country:US
Practice Address - Phone:570-764-2049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-04
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1297281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical