Provider Demographics
NPI:1225118318
Name:VELEZ, ANDREA LYN (LMSW)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:LYN
Last Name:VELEZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1881 CAMERON RD
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:MI
Mailing Address - Zip Code:48002-2211
Mailing Address - Country:US
Mailing Address - Phone:810-434-0829
Mailing Address - Fax:
Practice Address - Street 1:3111 ELECTRIC AVE
Practice Address - Street 2:
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-8127
Practice Address - Country:US
Practice Address - Phone:810-985-8900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical