Provider Demographics
NPI:1295229474
Name:SHECKLER, ANDREA TRACY (MS, LPC)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:TRACY
Last Name:SHECKLER
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:898 PARK AVE STE 16
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-3335
Mailing Address - Country:US
Mailing Address - Phone:814-807-0487
Mailing Address - Fax:888-538-2885
Practice Address - Street 1:898 PARK AVE STE 16
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-3335
Practice Address - Country:US
Practice Address - Phone:814-807-0487
Practice Address - Fax:888-538-2885
Is Sole Proprietor?:No
Enumeration Date:2018-06-20
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC010466101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health