Provider Demographics
NPI:1033296595
Name:LOCKNER, ANDREA JEAN
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:JEAN
Last Name:LOCKNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 E 3RD ST STE 101
Mailing Address - Street 2:
Mailing Address - City:THE DALLES
Mailing Address - State:OR
Mailing Address - Zip Code:97058-2563
Mailing Address - Country:US
Mailing Address - Phone:541-298-2101
Mailing Address - Fax:541-298-7996
Practice Address - Street 1:401 E 3RD ST STE 101
Practice Address - Street 2:
Practice Address - City:THE DALLES
Practice Address - State:OR
Practice Address - Zip Code:97058-2563
Practice Address - Country:US
Practice Address - Phone:541-298-2101
Practice Address - Fax:541-298-7996
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)