Provider Demographics
NPI:1518453737
Name:NAVE, ANDREA MARIE (MA, LPC)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:MARIE
Last Name:NAVE
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 FOREST PARK DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-1499
Mailing Address - Country:US
Mailing Address - Phone:608-269-6538
Mailing Address - Fax:860-269-8621
Practice Address - Street 1:10 FOREST PARK DR
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-1499
Practice Address - Country:US
Practice Address - Phone:860-269-6538
Practice Address - Fax:860-269-8621
Is Sole Proprietor?:No
Enumeration Date:2018-07-11
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CT3745101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program