Provider Demographics
NPI:1619456902
Name:ARELLANO EURIBE, ANDREA PENELOPE (LGPC)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:PENELOPE
Last Name:ARELLANO EURIBE
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 COATBRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832
Mailing Address - Country:US
Mailing Address - Phone:301-335-9730
Mailing Address - Fax:
Practice Address - Street 1:10715 CHARTER DRIVE #130
Practice Address - Street 2:DISCOVER YOURSELF WELLNESS CENTER
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044
Practice Address - Country:US
Practice Address - Phone:443-653-1363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-08
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MDLPG10215101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program