Provider Demographics
NPI:1164522058
Name:ANDREWS, VIVIAN (LPC)
Entity Type:Individual
Prefix:
First Name:VIVIAN
Middle Name:
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1045 MAIN STREET, SUITE 5
Mailing Address - Street 2:COUNSELING AND PSYCHOLOGICAL SERVICES, LLC
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-1800
Mailing Address - Country:US
Mailing Address - Phone:434-792-2277
Mailing Address - Fax:434-792-2279
Practice Address - Street 1:108 HOLBROOK ST
Practice Address - Street 2:SUITE 203
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-1758
Practice Address - Country:US
Practice Address - Phone:434-791-2059
Practice Address - Fax:434-791-2835
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002722101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
005413982Medicare ID - Type Unspecified