Individual
ANDREA HIMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, SAC
Contact information
Practice address
601 LAKE AVE STE 101C, RACINE, WI 53403-1249
(612) 562-4874
Mailing address
601 LAKE AVE STE 101C, RACINE, WI 53403-1249
(612) 562-4874
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
16610
WI
101YP2500X
Professional Counselor
Primary
8754
WI
Other
Enumeration date
03/10/2022
Last updated
08/24/2023
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