Provider Demographics
NPI:1629640487
Name:SCOURBY, ANDREA ELIZABETH (LMSW, CSW-INTERN)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:ELIZABETH
Last Name:SCOURBY
Suffix:
Gender:F
Credentials:LMSW, CSW-INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6151 LAKESIDE DR STE 2000
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-8541
Mailing Address - Country:US
Mailing Address - Phone:775-561-4328
Mailing Address - Fax:775-900-9631
Practice Address - Street 1:6151 LAKESIDE DR STE 2000
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-8541
Practice Address - Country:US
Practice Address - Phone:775-997-5373
Practice Address - Fax:775-954-1406
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-12
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV101YA0400X
NV12422-M104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)