Provider Demographics
NPI:1629567862
Name:ANDREWS, LUCY P (BHA-1)
Entity Type:Individual
Prefix:
First Name:LUCY
Middle Name:P
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:BHA-1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 130
Mailing Address - Street 2:
Mailing Address - City:DILLINGHAM
Mailing Address - State:AK
Mailing Address - Zip Code:99576-0130
Mailing Address - Country:US
Mailing Address - Phone:907-493-5015
Mailing Address - Fax:
Practice Address - Street 1:6000 KANAKANAK RD.
Practice Address - Street 2:TOGIAK CLINIC
Practice Address - City:DILLINGHAM
Practice Address - State:AK
Practice Address - Zip Code:99576-0130
Practice Address - Country:US
Practice Address - Phone:907-493-5015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-03
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK17-119-BHAI101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK17-119-BHAIOtherSTATE OF ALASK BHA BOARD