Healthcare Provider Details

I. General information

NPI: 1326097783
Provider Name (Legal Business Name): SANDRA LEE ANDREASEN MS, LMFT, LPC, LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 02/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1406 6TH AVENUE NORTH ST. CLOUD HOSPITAL
ST. CLOUD MN
56303-1901
US

IV. Provider business mailing address

1406 6TH AVENUE NORTH ST. CLOUD HOSPITAL
ST. CLOUD MN
56303-1901
US

V. Phone/Fax

Practice location:
  • Phone: 320-251-2700
  • Fax: 320-656-7115
Mailing address:
  • Phone: 320-251-2700
  • Fax: 320-656-7115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6453
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number00447(LPC)
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number1898(LAMFT)
License Number StateMN
# 4
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number1898
License Number StateMN
# 5
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number447
License Number StateMN
# 6
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6453
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: