Provider Demographics
NPI:1609063874
Name:ANDAVERDE, SANDY PEREZ (LPC-S)
Entity Type:Individual
Prefix:
First Name:SANDY
Middle Name:PEREZ
Last Name:ANDAVERDE
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:MS
Other - First Name:SANDY
Other - Middle Name:
Other - Last Name:PEREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:207 ALAN-A-DALE
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521
Mailing Address - Country:US
Mailing Address - Phone:956-222-9588
Mailing Address - Fax:
Practice Address - Street 1:207 ALAN-A-DALE
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521
Practice Address - Country:US
Practice Address - Phone:956-222-9588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-01
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61639101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional