Provider Demographics
NPI:1174110183
Name:LAYNE, ANDREA COURTNEY PARIS (LMHC)
Entity type:Individual
Prefix:MISS
First Name:ANDREA
Middle Name:COURTNEY PARIS
Last Name:LAYNE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:LYNN
Other - Last Name:COURTNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:TLMHC
Mailing Address - Street 1:1825 CALEB CT UNIT 107
Mailing Address - Street 2:
Mailing Address - City:NORTH LIBERTY
Mailing Address - State:IA
Mailing Address - Zip Code:52317-8848
Mailing Address - Country:US
Mailing Address - Phone:319-759-3967
Mailing Address - Fax:
Practice Address - Street 1:209 E WASHINGTON ST STE 305A
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-3928
Practice Address - Country:US
Practice Address - Phone:506-931-9849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-23
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA100474101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health