Individual
MR. JERRY ANDREWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFT, LISAC
Contact information
Practice address
17100 N 67TH AVE, 400, GLENDALE, AZ 85308-3605
(602) 938-3323
(602) 938-1626
Mailing address
17100 N 67TH AVE, 400, GLENDALE, AZ 85308-3605
(602) 938-3323
(602) 938-1626
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LISAC-10135
AZ
106H00000X
Marriage & Family Therapist
Primary
LMFT-10178
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LISAC-10135
THERAPIST
AZ
01
—
LMFT-10178
THERAPIST
AZ
Enumeration date
11/07/2006
Last updated
03/27/2013
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