Andrea Shaw, LCSW | |
552 Edwardsville Rd, Troy, IL 62294-1338 | |
(618) 520-6963 | |
Not Available |
Full Name | Andrea Shaw |
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Gender | Female |
Speciality | Social Worker - Clinical |
Location | 552 Edwardsville Rd, Troy, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1851463004 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 149011548 (Illinois) | Primary |
Entity Name | Grow Healthcare Group Pa |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20220414000139 |
Mailing Address | Practice Location Address |
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Andrea Shaw, LCSW 552 Edwardsville Rd, Troy, IL 62294-1338 Ph: (618) 520-6963 | Andrea Shaw, LCSW 552 Edwardsville Rd, Troy, IL 62294-1338 Ph: (618) 520-6963 |
Mrs. Diona Ranee Shelton, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 189 E Us Highway 40 Ste D, Troy, IL 62294 Phone: 618-744-0844 Fax: 618-505-5044 | |
Tracy Lewis, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 189 E Us Highway 40 Ste D, Troy, IL 62294 Phone: 773-562-0672 | |
Amy Haerr, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1424 Bridgehampton Rd, Troy, IL 62294 Phone: 302-404-4617 |