Provider Demographics
NPI:1891420683
Name:ANDREWS, MADISON (LPCC)
Entity Type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10943 RHODE ISLAND AVE S
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55438-2373
Mailing Address - Country:US
Mailing Address - Phone:612-408-3269
Mailing Address - Fax:
Practice Address - Street 1:2724 UNIVERSITY AVE SE UNIT B
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55414-3210
Practice Address - Country:US
Practice Address - Phone:612-299-1090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2896101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health