Provider Demographics
NPI:1497036339
Name:KLIEBERT, ANDREA NAUL (LPC)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:NAUL
Last Name:KLIEBERT
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 1:70125 8TH ST
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-5590
Mailing Address - Country:US
Mailing Address - Phone:985-234-9176
Mailing Address - Fax:985-234-9176
Practice Address - Street 1:1011 N CAUSEWAY BLVD
Practice Address - Street 2:SUITE 28
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70471-3243
Practice Address - Country:US
Practice Address - Phone:985-624-6631
Practice Address - Fax:985-624-6617
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-06
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3325101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional