Provider Demographics
NPI:1831246602
Name:HOLZMAN, ANDREW S (MPS, LMFT)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:S
Last Name:HOLZMAN
Suffix:
Gender:M
Credentials:MPS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1947 BECHTEL RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-1501
Mailing Address - Country:US
Mailing Address - Phone:317-457-8668
Mailing Address - Fax:317-844-6430
Practice Address - Street 1:703 PRO-MED LN
Practice Address - Street 2:102
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-5317
Practice Address - Country:US
Practice Address - Phone:317-457-8668
Practice Address - Fax:317-844-6430
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN35001269A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000184043OtherANTHEM BLUE CROSSBLUE SH