Provider Demographics
NPI:1487867594
Name:VRENTAS, ANDREA LEE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:LEE
Last Name:VRENTAS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:STOERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2303 RANCH ROAD 620 S
Mailing Address - Street 2:#135-455
Mailing Address - City:LAKEWAY
Mailing Address - State:TX
Mailing Address - Zip Code:78734-6219
Mailing Address - Country:US
Mailing Address - Phone:512-810-9101
Mailing Address - Fax:
Practice Address - Street 1:2501 W WILLIAM CANNON DR
Practice Address - Street 2:BUILDING 6 SUITE A
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-5281
Practice Address - Country:US
Practice Address - Phone:512-344-9181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18954101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health