Provider Demographics
NPI:1720191067
Name:HARBAUGH, ANDREA DEL (LPC)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:DEL
Last Name:HARBAUGH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:ANDREA
Other - Middle Name:D
Other - Last Name:HARBAUGH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:7571 TERRY DR
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-6477
Mailing Address - Country:US
Mailing Address - Phone:817-320-1883
Mailing Address - Fax:817-684-8445
Practice Address - Street 1:5017 HERITAGE AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-5994
Practice Address - Country:US
Practice Address - Phone:817-320-1883
Practice Address - Fax:817-684-8445
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15280101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1462442-01Medicaid