Provider Demographics
NPI:1114551942
Name:ABSHIRE, ANDREA CLONINGER (LPC)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:CLONINGER
Last Name:ABSHIRE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:253 DUBLIN CT SW
Mailing Address - Street 2:
Mailing Address - City:MABLETON
Mailing Address - State:GA
Mailing Address - Zip Code:30126-1730
Mailing Address - Country:US
Mailing Address - Phone:770-630-2353
Mailing Address - Fax:
Practice Address - Street 1:540 POWDER SPRINGS ST. BUILDING C STE 17
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-3549
Practice Address - Country:US
Practice Address - Phone:770-630-2353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-02
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA011113101YP2500X, 101YP2500X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)