Provider Demographics
NPI:1114324654
Name:MCANDREWS, KAMARA (MA, LMFT, DAACS)
Entity Type:Individual
Prefix:
First Name:KAMARA
Middle Name:
Last Name:MCANDREWS
Suffix:
Gender:F
Credentials:MA, LMFT, DAACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 BOULDER CRESCENT ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-3344
Mailing Address - Country:US
Mailing Address - Phone:719-684-3638
Mailing Address - Fax:
Practice Address - Street 1:10 BOULDER CRESCENT ST
Practice Address - Street 2:SUITE 301
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-3344
Practice Address - Country:US
Practice Address - Phone:719-684-3638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-27
Last Update Date:2014-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO702106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO54-2180027OtherTAX IDENTIFICATION NUMBER