Provider Demographics
NPI:1962371286
Name:PRAUS, ANDREA JEAN (LAPC)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:JEAN
Last Name:PRAUS
Suffix:
Gender:F
Credentials:LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1068 CARROLL ST
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:ND
Mailing Address - Zip Code:58601-5432
Mailing Address - Country:US
Mailing Address - Phone:701-290-5606
Mailing Address - Fax:701-290-5606
Practice Address - Street 1:10 2ND ST W STE A
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:ND
Practice Address - Zip Code:58601-5384
Practice Address - Country:US
Practice Address - Phone:701-264-9049
Practice Address - Fax:701-483-4781
Is Sole Proprietor?:No
Enumeration Date:2025-11-04
Last Update Date:2025-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1510-11-1-25A101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional