Provider Demographics
NPI:1417551094
Name:ANDREANA MABRY, LICENSED MARRIAGE AND FAMILY THERAPIST
Entity Type:Organization
Organization Name:ANDREANA MABRY, LICENSED MARRIAGE AND FAMILY THERAPIST
Other - Org Name:SHOW UP COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/CLINICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANDREANA
Authorized Official - Middle Name:
Authorized Official - Last Name:MABRY
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:909-402-2535
Mailing Address - Street 1:9431 HAVEN AVE STE 229
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-5848
Mailing Address - Country:US
Mailing Address - Phone:909-402-2535
Mailing Address - Fax:
Practice Address - Street 1:10601 CIVIC CENTER DR STE 100BC
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-3878
Practice Address - Country:US
Practice Address - Phone:909-402-2535
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-24
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health