Individual provider Active NPI

Andrea Kae Brower

  • Addiction (Substance Use Disorder) Counselor
  • Lynnwood, WA
National Provider Identifier
1194592899
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CO61262883 Issued in WA
Practice address
20508 56TH Ave W
Lynnwood, WA 98036-7650
Phone
(425) 678-1390
NPI assigned
Dec 4, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CO61262883 WA Primary

Addresses

Primary practice location

20508 56TH Ave W
Lynnwood, WA 98036-7650

Mailing address

20508 56TH Ave W
Lynnwood, WA 98036-7650
Phone (425) 678-1390

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CO61262883WAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Evergreen Recovery Centers-Health Services CurrentSince Dec 10, 2023 Accepting new patients
Evergreen Recovery Centers-Lynnwood Detox PastSince Dec 10, 2023 Accepting new patients

Locations

20508 56th Ave W
Lynnwood, WA 98036
Phone (425) 678-1390

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1701648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1194592899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20508 56TH AVE W",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980367650",
            "telephone_number": "425-678-1390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20508 56TH AVE W",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980367650",
            "telephone_number": "425-678-1390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWER",
        "first_name": "ANDREA",
        "middle_name": "KAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-04",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CO61262883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.