Provider Demographics
NPI:1003287541
Name:ANDRADE, LYNNE MARIE (MA, LPCC, NCC)
Entity Type:Individual
Prefix:
First Name:LYNNE
Middle Name:MARIE
Last Name:ANDRADE
Suffix:
Gender:F
Credentials:MA, LPCC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3360 EVERETT DR
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80305-6901
Mailing Address - Country:US
Mailing Address - Phone:970-532-9999
Mailing Address - Fax:
Practice Address - Street 1:3360 EVERETT DR
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80305-6901
Practice Address - Country:US
Practice Address - Phone:970-532-9999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-09
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0014097101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health