Provider Demographics
NPI:1366107203
Name:ANDREA, MAURICE (LMFT)
Entity type:Individual
Prefix:
First Name:MAURICE
Middle Name:
Last Name:ANDREA
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91-748 LAUNAHELE ST
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-4755
Mailing Address - Country:US
Mailing Address - Phone:808-445-0541
Mailing Address - Fax:
Practice Address - Street 1:95-1091 AINAMAKUA DR
Practice Address - Street 2:
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-4252
Practice Address - Country:US
Practice Address - Phone:808-204-4020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-04
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor