MEDICARE: ANDREA GREW LPC

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1770124281
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANDREA GREW LPC

Provider Business Mailing Address
First Line	:	57037 CURTIS ST
Second Line	:
City	:	WASHINGTON TOWNSHIP
State	:	MI
Zip	:	48094-3844
Country	:	US
Telephone Number	:	586-709-7620
Fax Number	:

Provider Business Practice Location Address
First Line	:	57037 CURTIS ST
Second Line	:
City	:	WASHINGTON TOWNSHIP
State	:	MI
Zip	:	48094-3844
Country	:	US
Telephone Number	:	586-709-7620
Fax Number	:

Authorized Official
Title or Position	:	MENTAL HEALTH COUNSELOR
Name	:	ANDREA GREW
Credential	:
Telephone Number	:	586-745-0735

Provider Enumeration Date	:	10/05/2019
Last Update Date	:	10/05/2019

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