Provider Demographics
NPI:1013373463
Name:ANDRES, JOAN
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:ANDRES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 CENTRAL AVE NW STE 1300
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51041-1331
Mailing Address - Country:US
Mailing Address - Phone:712-360-0399
Mailing Address - Fax:712-737-9241
Practice Address - Street 1:400 CENTRAL AVE NW STE 1300
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:IA
Practice Address - Zip Code:51041-1331
Practice Address - Country:US
Practice Address - Phone:712-360-0399
Practice Address - Fax:712-737-9241
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-14
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00693101YM0800X
IA00207106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health