Provider Demographics
NPI:1225311632
Name:SCHWAIN, ANDREA KIRSTEN (MA, LADC, LAMFT)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:KIRSTEN
Last Name:SCHWAIN
Suffix:
Gender:F
Credentials:MA, LADC, LAMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4725 EXCELSIOR BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-3047
Mailing Address - Country:US
Mailing Address - Phone:612-325-2919
Mailing Address - Fax:
Practice Address - Street 1:4725 EXCELSIOR BLVD STE 400
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-3047
Practice Address - Country:US
Practice Address - Phone:612-325-2919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-21
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN302161101YA0400X
MN2594101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health