Cherry L. Andre, LMSW
Individual provider Active NPI Social Worker · Canton, NY
NPI 1255738522 · NPPES record last updated Dec 2, 2014
Key facts
- NPI
- 1255738522
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 091656 (NY)
- Practice address
- 80 State Highway 310
Suite 1
Canton, NY 13617 - Phone
- (315) 386-2167
- Fax
- (315) 386-2435
- NPI assigned
- Dec 2, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 091656 | NY | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Lawrence County | Social Worker | Past |
Accepting new patients |
| St Lawrence County | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 091656 | NY | Yes |
Addresses
Primary practice location
80 State Highway 310
Suite 1
Canton, NY 13617
Mailing address
80 State Highway 310
Suite 1
Canton, NY 13617
Phone (315) 386-2167
Other names
- Cherry L Tedd
Other providers in Canton, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 2, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.