Provider Demographics
NPI:1972130805
Name:MILEWSKI, ANDREA LOPER (LMFT)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:LOPER
Last Name:MILEWSKI
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 1:180 KENSINGTON AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06051-3926
Mailing Address - Country:US
Mailing Address - Phone:860-368-8985
Mailing Address - Fax:
Practice Address - Street 1:180 KENSINGTON AVE APT 1
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06051-3926
Practice Address - Country:US
Practice Address - Phone:860-368-8985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-23
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002158106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist