Provider Demographics
NPI:1871881391
Name:ANDREWS, CAROL (MFT)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:659 CHERRY ST STE 202
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95404-4281
Mailing Address - Country:US
Mailing Address - Phone:707-849-6193
Mailing Address - Fax:
Practice Address - Street 1:659 CHERRY ST STE 202
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95404-4281
Practice Address - Country:US
Practice Address - Phone:707-849-6193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-18
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53782106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist