Provider Demographics
NPI:1013192707
Name:ANDES, RONALD LEE (LPC)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:LEE
Last Name:ANDES
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 RIDGECREST DR
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-6343
Mailing Address - Country:US
Mailing Address - Phone:505-471-9154
Mailing Address - Fax:505-438-9592
Practice Address - Street 1:138 RIDGECREST DR
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-6343
Practice Address - Country:US
Practice Address - Phone:505-471-9154
Practice Address - Fax:505-438-9592
Is Sole Proprietor?:No
Enumeration Date:2008-01-01
Last Update Date:2008-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMLPC0915101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health