ANDREA PETROVICH LPC NPI 1639181548

NPI Information

NPI: 1639181548
Provider Name: ANDREA PETROVICH, LPC
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

Address:
107 WOODBINE PLACE
#775
LONGVIEW, TX
ZIP 75608
Phone: (903) 757-8194
Get Directions

Andrea Petrovich, LPC is a professional counselor in Longview, TX. Andrea Petrovich, LPC NPI is 1639181548. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

107 WOODBINE PLACE
#775
LONGVIEW, TX
ZIP 75608
Phone: (903) 757-8194
Fax: (903) 757-8294

The enumeration date for this NPI number is 8/12/2006 and was last updated on 10/4/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	MH6732	FLORIDA	No
2	101YP2500X	Counselor	Professional	66633-TX	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	761879400	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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