Provider Demographics
NPI:1477252351
Name:MCIVER HERNANDEZ, DEANDREA RENE' (LPCC)
Entity Type:Individual
Prefix:
First Name:DEANDREA
Middle Name:RENE'
Last Name:MCIVER HERNANDEZ
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:DEANDREA
Other - Middle Name:RENE'
Other - Last Name:HERNANDEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8461 TURNPIKE DR STE 102
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-4378
Mailing Address - Country:US
Mailing Address - Phone:720-515-4244
Mailing Address - Fax:
Practice Address - Street 1:8461 TURNPIKE DR STE 102
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-4378
Practice Address - Country:US
Practice Address - Phone:720-515-4244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-28
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0020457101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor