Provider Demographics
NPI:1033583943
Name:ANDRUS, STEVEN BRENT (LCPC)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:BRENT
Last Name:ANDRUS
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:MR
Other - First Name:STEVEN
Other - Middle Name:BRENT
Other - Last Name:ANDRUS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, LCPC
Mailing Address - Street 1:125 ALGONQUIN DR
Mailing Address - Street 2:
Mailing Address - City:RISING SUN
Mailing Address - State:MD
Mailing Address - Zip Code:21911-1315
Mailing Address - Country:US
Mailing Address - Phone:601-559-6337
Mailing Address - Fax:
Practice Address - Street 1:125 ALGONQUIN DR
Practice Address - Street 2:
Practice Address - City:RISING SUN
Practice Address - State:MD
Practice Address - Zip Code:21911-1315
Practice Address - Country:US
Practice Address - Phone:601-559-6337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-17
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC8047101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional