Provider Demographics
NPI:1982099511
Name:ETUK, ANDREW (LCSW)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:ETUK
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10333 HARWIN DR 535D
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-1532
Mailing Address - Country:US
Mailing Address - Phone:713-482-1029
Mailing Address - Fax:
Practice Address - Street 1:10333 HARWIN DR 535D
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-1532
Practice Address - Country:US
Practice Address - Phone:713-482-1029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-31
Last Update Date:2015-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX528471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical