Provider Demographics
NPI:1861818577
Name:RAWAT, ANDREA (LLPC)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:RAWAT
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3533 FORT KNOX DR
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-2953
Mailing Address - Country:US
Mailing Address - Phone:810-667-9099
Mailing Address - Fax:
Practice Address - Street 1:3533 FORT KNOX DR
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-2953
Practice Address - Country:US
Practice Address - Phone:810-667-9099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-06
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401014153101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional