Provider Demographics
NPI:1336444082
Name:NEWHOUSE, ANDREW DEAN
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:DEAN
Last Name:NEWHOUSE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 470
Mailing Address - Street 2:
Mailing Address - City:NAALEHU
Mailing Address - State:HI
Mailing Address - Zip Code:96772-1000
Mailing Address - Country:US
Mailing Address - Phone:661-204-2405
Mailing Address - Fax:661-868-6666
Practice Address - Street 1:PO BOX 470
Practice Address - Street 2:
Practice Address - City:NAALEHU
Practice Address - State:HI
Practice Address - Zip Code:96772-1000
Practice Address - Country:US
Practice Address - Phone:661-204-2405
Practice Address - Fax:661-868-6666
Is Sole Proprietor?:No
Enumeration Date:2011-01-11
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
SC8099106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator