Provider Demographics
NPI:1396203212
Name:ANDREWS, OFELIA Z (LPC)
Entity Type:Individual
Prefix:MS
First Name:OFELIA
Middle Name:Z
Last Name:ANDREWS
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 1:5130 N ICE SPRINGS WAY
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83713-2040
Mailing Address - Country:US
Mailing Address - Phone:208-953-7721
Mailing Address - Fax:208-963-3601
Practice Address - Street 1:1406 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-1795
Practice Address - Country:US
Practice Address - Phone:208-953-7721
Practice Address - Fax:208-963-3106
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-10
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC-6514101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1396203212Medicaid