Provider Demographics
NPI:1154897114
Name:ANDRUSKI FAMILY COUNSELING INC
Entity type:Organization
Organization Name:ANDRUSKI FAMILY COUNSELING INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KASEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDRUSKI
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:760-403-3845
Mailing Address - Street 1:PO BOX 291881
Mailing Address - Street 2:
Mailing Address - City:PHELAN
Mailing Address - State:CA
Mailing Address - Zip Code:92329-1881
Mailing Address - Country:US
Mailing Address - Phone:760-403-3845
Mailing Address - Fax:442-267-5241
Practice Address - Street 1:17130 SEQUOIA ST STE 103
Practice Address - Street 2:
Practice Address - City:HESPERIA
Practice Address - State:CA
Practice Address - Zip Code:92345-1827
Practice Address - Country:US
Practice Address - Phone:760-403-3845
Practice Address - Fax:442-267-5241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-17
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty