Basic Information
| Provider Information | |||||||||
| NPI: | 1326097783 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ANDREASEN | ||||||||
| FirstName: | SANDRA | ||||||||
| MiddleName: | LEE | ||||||||
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| Credential: | MS, LMFT, LPC, LSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1406 6TH AVENUE NORTH | ||||||||
| Address2: | ST. CLOUD HOSPITAL | ||||||||
| City: | ST. CLOUD | ||||||||
| State: | MN | ||||||||
| PostalCode: | 563031901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3202512700 | ||||||||
| FaxNumber: | 3206567115 | ||||||||
| Practice Location | |||||||||
| Address1: | 1406 6TH AVENUE NORTH | ||||||||
| Address2: | ST. CLOUD HOSPITAL | ||||||||
| City: | ST. CLOUD | ||||||||
| State: | MN | ||||||||
| PostalCode: | 563031901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3202512700 | ||||||||
| FaxNumber: | 3206567115 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/10/2006 | ||||||||
| LastUpdateDate: | 02/20/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 6453 | MN | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YP2500X | 00447(LPC) | MN | N | Behavioral Health & Social Service Providers | Counselor | Professional | 106H00000X | 1898(LAMFT) | MN | N | Behavioral Health & Social Service Providers | Marriage & Family Therapist | 106H00000X | 1898 | MN | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist | 101YP1600X | 447 | MN | N | Behavioral Health & Social Service Providers | Counselor | Pastoral | 104100000X | 6453 | MN | N | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.