Healthcare Provider Details

I. General information

NPI: 1780258731
Provider Name (Legal Business Name): ANDREW HEY LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2021
Last Update Date: 04/13/2022
Certification Date: 04/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4833 MINNETONKA BLVD
SAINT LOUIS PARK MN
55416-2214
US

IV. Provider business mailing address

4833 MINNETONKA BLVD
SAINT LOUIS PARK MN
55416-2214
US

V. Phone/Fax

Practice location:
  • Phone: 612-567-1338
  • Fax:
Mailing address:
  • Phone: 612-567-1338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3279
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3279
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number01966
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: