Provider Demographics
NPI:1063514081
Name:CARSTENS, ANDREA KAY (PHD)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:KAY
Last Name:CARSTENS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31ST MEDICAL GROUP, UNIT 6180
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09604-6180
Mailing Address - Country:US
Mailing Address - Phone:314-632-5105
Mailing Address - Fax:
Practice Address - Street 1:31ST MEDICAL GROUP, UNIT 6180
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09604-6180
Practice Address - Country:US
Practice Address - Phone:314-632-5105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY002452103T00000X
AL2034103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
68BBGKKMedicare ID - Type Unspecified
R43689Medicare UPIN