Andrea D Keys, LADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

302219 Issued in MN

Practice address

6000 Bass Lake Road
Suite #201
Crystal, MN 55429

Phone

(612) 578-7901

Fax

(612) 600-6956

NPI assigned

Jul 17, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1247788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559174400000",
    "number": "1861622300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 BASS LAKE ROAD",
            "address_2": "SUITE #201",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554292794",
            "telephone_number": "612-578-7901",
            "fax_number": "612-600-6956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 BASS LAKE ROAD",
            "address_2": "SUITE #201",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "55429",
            "telephone_number": "612-578-7901",
            "fax_number": "612-600-6956"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1121 Jackson St NE",
            "address_2": "Suite 105",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554131672",
            "country_code": "US",
            "telephone_number": "612-236-1700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEYS",
        "first_name": "ANDREA",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "LADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-17",
        "last_updated": "2019-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "302219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "302219",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Crystal, MN
• Providers in Crystal, MN by specialty
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2019; 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.