Provider Demographics
NPI:1548459365
Name:GUERTIN, ANDREA HELENE (LPC, LBSW)
Entity type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:HELENE
Last Name:GUERTIN
Suffix:
Gender:F
Credentials:LPC, LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17346 BEECH DALY RD
Mailing Address - Street 2:
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48240-2221
Mailing Address - Country:US
Mailing Address - Phone:313-794-1029
Mailing Address - Fax:
Practice Address - Street 1:17346 BEECH DALY RD
Practice Address - Street 2:
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48240-2221
Practice Address - Country:US
Practice Address - Phone:313-794-1029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-17
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL705955101YP2500X
MIL1073750104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No104100000XBehavioral Health & Social Service ProvidersSocial Worker