Provider Demographics
NPI:1013449735
Name:KRITOVICH, ANDREW (LMHC)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:KRITOVICH
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30012 41ST AVE S
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98001-2216
Mailing Address - Country:US
Mailing Address - Phone:206-334-8702
Mailing Address - Fax:253-941-6577
Practice Address - Street 1:30012 41ST AVE S
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98001-2216
Practice Address - Country:US
Practice Address - Phone:206-334-8702
Practice Address - Fax:253-941-6577
Is Sole Proprietor?:No
Enumeration Date:2017-03-31
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60426203101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health