Provider Demographics
NPI:1659816361
Name:CHANDLER, ANDREA (MS, LCDC, LPCI)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:MS, LCDC, LPCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:365 W RUSK ST
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-3603
Mailing Address - Country:US
Mailing Address - Phone:972-800-2023
Mailing Address - Fax:972-755-1894
Practice Address - Street 1:365 W RUSK ST
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-3603
Practice Address - Country:US
Practice Address - Phone:972-800-2023
Practice Address - Fax:972-755-1894
Is Sole Proprietor?:No
Enumeration Date:2017-01-04
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13729101YA0400X
TX75337101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional