Individual
MR. ANDREW ROBESON TIDRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
219 W MAGNOLIA ST, SUITE 120, FORT COLLINS, CO 80521-2811
(512) 691-6025
(877) 226-2395
Mailing address
219 W MAGNOLIA ST, SUITE 120, FORT COLLINS, CO 80521-2811
(512) 691-6025
(877) 226-2395
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
09923286
CO
1041C0700X
Clinical Social Worker
27843
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
040521902
—
TX
01
—
09923286
COLORADO LCSW
CO
01
—
11964870
CAQH
—
Enumeration date
01/08/2007
Last updated
10/28/2013
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