Provider Demographics
NPI:1871142398
Name:PERRYMAN, ANDRA MCCRORY (LCSW)
Entity type:Individual
Prefix:
First Name:ANDRA
Middle Name:MCCRORY
Last Name:PERRYMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ANDRA
Other - Middle Name:MAY
Other - Last Name:MCCRORY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4159 E PEACH TREE DR
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85249-7349
Mailing Address - Country:US
Mailing Address - Phone:224-628-0495
Mailing Address - Fax:
Practice Address - Street 1:1166 E WARNER RD STE 205204B
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-3064
Practice Address - Country:US
Practice Address - Phone:480-702-1605
Practice Address - Fax:480-452-0435
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-06
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ157261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical