MEDICARE: ANDREA HELEN LINDQUIST LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	LCSW19823	CA

General Provider Information

NPI Number	:	1417450131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA HELEN LINDQUIST LCSW

Provider Business Mailing Address
First Line	:	17591 CROWN CIR
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92649
Country	:	US
Telephone Number	:	714-330-8070
Fax Number	:

Provider Business Practice Location Address
First Line	:	16531 BOLSA CHICA ST
Second Line	:	STE 345
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92649-3595
Country	:	US
Telephone Number	:	714-593-9630
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2018
Last Update Date	:	04/17/2020

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