Provider Demographics
NPI:1659697530
Name:ZAVITZ, ANDREA M (LPC, LMHC, NCC)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:M
Last Name:ZAVITZ
Suffix:
Gender:F
Credentials:LPC, LMHC, NCC
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:M
Other - Last Name:GODFREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC, LMHC, NCC
Mailing Address - Street 1:683 CHARLESTON MILLS DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND CITY
Mailing Address - State:AL
Mailing Address - Zip Code:36350-6050
Mailing Address - Country:US
Mailing Address - Phone:863-286-1812
Mailing Address - Fax:
Practice Address - Street 1:1865 HONEYSUCKLE RD
Practice Address - Street 2:SUITE 2B
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36305-4286
Practice Address - Country:US
Practice Address - Phone:334-793-8111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-16
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 11581101YM0800X
171M00000X
ALLPC 3201101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL007967100Medicaid