Provider Demographics
NPI:1255659736
Name:SANTI, ANDREW (LPC)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:SANTI
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 1:1208 W MAGNOLIA AVE STE 236
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-8801
Mailing Address - Country:US
Mailing Address - Phone:817-380-8833
Mailing Address - Fax:
Practice Address - Street 1:1208 W MAGNOLIA AVE STE 236
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-8801
Practice Address - Country:US
Practice Address - Phone:817-380-8833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-09
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63185101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional