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General NPI Number Information
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NPI Number | 1437725942
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Entity Type | Individual
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Provider Name | ANDREA MORTENSEN LMFT
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Gender | Female
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Dates
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Enumeration Date | 06/03/2021
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 37 W 26TH ST RM 1201
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City | NEW YORK
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State | NY
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Zip | 10010-1053
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Country | US
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Telephone | 917-426-1393
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Fax |
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Provider Business Mailing Address
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Address Line | 156 5TH AVE STE 1223
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City | NEW YORK
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State | NY
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Zip | 10010-7735
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Country | US
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Telephone | 646-661-4055
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 002330
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 109054
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License Number State | NY
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