Healthcare Provider Details

I. General information

NPI: 1740796184
Provider Name (Legal Business Name): MICHELLE LORRAINE ANDREWS MA, ED.D, BCCP, LCAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MICHELLE LORRAINE ANDREWS LCASA

II. Dates (important events)

Enumeration Date: 12/21/2017
Last Update Date: 07/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2706 N CHURCH ST
GREENSBORO NC
27405-3657
US

IV. Provider business mailing address

318 MELBOURNE RD
GREENSBORO NC
27405-4320
US

V. Phone/Fax

Practice location:
  • Phone: 336-272-9990
  • Fax:
Mailing address:
  • Phone: 281-748-4121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number24912
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: