Provider Demographics
NPI:1326389735
Name:ANDREWS, LISA CAROLYN (LPC, NCC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:CAROLYN
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1206 N ALTADENA AVE
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-3637
Mailing Address - Country:US
Mailing Address - Phone:248-761-1407
Mailing Address - Fax:
Practice Address - Street 1:1710 E 12 MILE RD STE 101
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-4200
Practice Address - Country:US
Practice Address - Phone:248-798-7798
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-09
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401013368101Y00000X, 101YM0800X, 101YP2500X
IA113165101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health