Provider Demographics
NPI:1144671785
Name:CARAWAY, ANDY (LPC)
Entity type:Individual
Prefix:
First Name:ANDY
Middle Name:
Last Name:CARAWAY
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:DEREK
Other - Middle Name:
Other - Last Name:CARAWAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8629 BLUEJACKET ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66214-1604
Mailing Address - Country:US
Mailing Address - Phone:913-677-3553
Mailing Address - Fax:913-677-3282
Practice Address - Street 1:8629 BLUEJACKET ST
Practice Address - Street 2:SUITE 100
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66214-1604
Practice Address - Country:US
Practice Address - Phone:913-677-3553
Practice Address - Fax:913-677-3282
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-24
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2918101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional