Provider Demographics
NPI:1215275003
Name:ANDRUS, STEVEN MAX (ACMHC)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:MAX
Last Name:ANDRUS
Suffix:
Gender:M
Credentials:ACMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2337 E OLYMPUS VISTA CT
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84124-2820
Mailing Address - Country:US
Mailing Address - Phone:801-516-9054
Mailing Address - Fax:
Practice Address - Street 1:1174 E GRAYSTONE WAY
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84106-2673
Practice Address - Country:US
Practice Address - Phone:801-516-9054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-29
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9060966-6009101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)