Provider Demographics
NPI:1790958874
Name:VANPATTEN, ANDREA NOEL (LMFT)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:NOEL
Last Name:VANPATTEN
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:PO BOX 790006
Mailing Address - Street 2:
Mailing Address - City:PAIA
Mailing Address - State:HI
Mailing Address - Zip Code:96779-0006
Mailing Address - Country:US
Mailing Address - Phone:808-269-4603
Mailing Address - Fax:808-579-6020
Practice Address - Street 1:913 BALDWIN AVE
Practice Address - Street 2:
Practice Address - City:PAIA
Practice Address - State:HI
Practice Address - Zip Code:96779
Practice Address - Country:US
Practice Address - Phone:808-269-4603
Practice Address - Fax:808-579-6020
Is Sole Proprietor?:No
Enumeration Date:2008-04-09
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
HI251106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health