Provider Demographics
NPI:1275881674
Name:BARLASS, ANDREA (LICSW)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:BARLASS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:BRIXIUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:15265 CARROUSEL WAY STE 100
Mailing Address - Street 2:
Mailing Address - City:ROSEMOUNT
Mailing Address - State:MN
Mailing Address - Zip Code:55068-1760
Mailing Address - Country:US
Mailing Address - Phone:952-443-4600
Mailing Address - Fax:
Practice Address - Street 1:15265 CARROUSEL WAY STE 100
Practice Address - Street 2:
Practice Address - City:ROSEMOUNT
Practice Address - State:MN
Practice Address - Zip Code:55068-1760
Practice Address - Country:US
Practice Address - Phone:951-443-4600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-16
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN250311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical