Provider Demographics
NPI:1417653049
Name:ERPENBACH, ANDREA RAE (MA, MFTA)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:RAE
Last Name:ERPENBACH
Suffix:
Gender:F
Credentials:MA, MFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2708 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-2637
Mailing Address - Country:US
Mailing Address - Phone:509-939-9558
Mailing Address - Fax:
Practice Address - Street 1:2708 JAMES ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-2637
Practice Address - Country:US
Practice Address - Phone:509-939-9558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMFTA.MG.61405642106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist