Healthcare Provider Details

I. General information

NPI: 1174952253
Provider Name (Legal Business Name): KATRINA ANDREWS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2013
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 S NEW HOPE RD
GASTONIA NC
28054-5829
US

IV. Provider business mailing address

901 S NEW HOPE RD
GASTONIA NC
28054-5829
US

V. Phone/Fax

Practice location:
  • Phone: 888-236-4673
  • Fax:
Mailing address:
  • Phone: 888-235-4673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA10110
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License NumberA10110
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: