Provider Demographics
NPI:1528376316
Name:ANDERSON-DUEBER, AMY P (LPC)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:P
Last Name:ANDERSON-DUEBER
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 1:1326 LAMAR SQUARE DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-8970
Mailing Address - Country:US
Mailing Address - Phone:512-443-1360
Mailing Address - Fax:512-703-1394
Practice Address - Street 1:1326 LAMAR SQUARE DR OFC 201
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-2243
Practice Address - Country:US
Practice Address - Phone:512-443-1360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-15
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62465101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX216765204Medicare PIN