Provider Demographics
NPI:1659838480
Name:NOFSINGER, ANDREA MARIE (LMSW)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:MARIE
Last Name:NOFSINGER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13433 152ND AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND HAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:49417-8510
Mailing Address - Country:US
Mailing Address - Phone:616-498-0851
Mailing Address - Fax:
Practice Address - Street 1:13433 152ND AVE
Practice Address - Street 2:
Practice Address - City:GRAND HAVEN
Practice Address - State:MI
Practice Address - Zip Code:49417-8510
Practice Address - Country:US
Practice Address - Phone:616-498-0851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-28
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011037781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical