Provider Demographics
NPI:1649635756
Name:LUNN, ANDREA SUZANNE (LMSW)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:SUZANNE
Last Name:LUNN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:SUZANNE
Other - Last Name:BEAULIEU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:10075 BERGIN RD STE C
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-7049
Mailing Address - Country:US
Mailing Address - Phone:810-444-2484
Mailing Address - Fax:810-272-4991
Practice Address - Street 1:10075 BERGIN RD
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-7049
Practice Address - Country:US
Practice Address - Phone:810-279-0515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-17
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010986421041C0700X
FLISW88761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical