Provider Demographics
NPI:1972817864
Name:KOUNEEV, ANDREA (MA, LMHC, NCC, OTR/L)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:KOUNEEV
Suffix:
Gender:F
Credentials:MA, LMHC, NCC, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3206 50TH STREET CT BLDG A
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-8556
Mailing Address - Country:US
Mailing Address - Phone:253-468-7899
Mailing Address - Fax:
Practice Address - Street 1:3206 50TH STREET CT BLDG A
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-8556
Practice Address - Country:US
Practice Address - Phone:253-468-7899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-03
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO225X00000X
WA61028551101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist