Provider Demographics
NPI:1003189721
Name:KANE FRANK, ANDREA R (MS, LCPC)
Entity type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:R
Last Name:KANE FRANK
Suffix:
Gender:F
Credentials:MS, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 SAINT CLAIRE PL
Mailing Address - Street 2:SUITE 101A
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21666-2177
Mailing Address - Country:US
Mailing Address - Phone:410-443-2840
Mailing Address - Fax:
Practice Address - Street 1:102 SAINT CLAIRE PL
Practice Address - Street 2:SUITE 101A
Practice Address - City:STEVENSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21666-2177
Practice Address - Country:US
Practice Address - Phone:410-443-2840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-10
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC4322101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health