Provider Demographics
NPI:1275882581
Name:SEBASTIAN, ANDREW (MA)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:SEBASTIAN
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:850 N HARRISON ST
Mailing Address - Street 2:ATTN: ANNE LAWSON
Mailing Address - City:WARSAW
Mailing Address - State:IN
Mailing Address - Zip Code:46580
Mailing Address - Country:US
Mailing Address - Phone:574-267-7169
Mailing Address - Fax:574-268-2377
Practice Address - Street 1:2860 NORTHPARK AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:IN
Practice Address - Zip Code:46750-9700
Practice Address - Country:US
Practice Address - Phone:260-356-2875
Practice Address - Fax:260-358-0611
Is Sole Proprietor?:No
Enumeration Date:2012-08-31
Last Update Date:2012-08-31
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health