Provider Demographics
NPI:1447301650
Name:ANDRUS, CLAIRE A (LLPC)
Entity type:Individual
Prefix:MS
First Name:CLAIRE
Middle Name:A
Last Name:ANDRUS
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9700 108TH ST SE
Mailing Address - Street 2:
Mailing Address - City:MIDDLEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49333-9328
Mailing Address - Country:US
Mailing Address - Phone:616-891-9396
Mailing Address - Fax:616-891-9396
Practice Address - Street 1:3501 LAKE EASTBROOK BLVD SE
Practice Address - Street 2:SUITE 262
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-5938
Practice Address - Country:US
Practice Address - Phone:616-977-5700
Practice Address - Fax:616-891-9396
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401008709101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health