| Doctor Name: | MR. ANDREW THOMASSON |
| NPI Number: | 1407175037 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW, CACII |
| License Number: | ACB6696 |
| Business Practice Address: | 191 E Agate Ave Granby, CO - 80446 |
| Business Phone Number: | 9705316173 |
| Business Fax Number: | 9708872293 |
| Mailing Address: | Po Box 964, GRAND LAKE |
| State: | CO |
| Postal Code: | 804470964 |
| Phone Number: | 9705316173 |
| Fax Number: | 9708872293 |
| NPI Enumeration Date: | 05/21/2010 |
| NPI Last Update Date: | 04/12/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | ACB6696 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |