Provider Demographics
NPI:1477896124
Name:NUS, ANDREA M (LMFT)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:M
Last Name:NUS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 33RD AVE SW STE X2
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52404-4646
Mailing Address - Country:US
Mailing Address - Phone:319-423-8033
Mailing Address - Fax:319-483-6793
Practice Address - Street 1:260 33RD AVE SW STE X2
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52404-4646
Practice Address - Country:US
Practice Address - Phone:319-423-8033
Practice Address - Fax:319-483-6793
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-01
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA000392106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist