Provider Demographics
NPI:1760707202
Name:HABRECHT-STASKO, ANDREA ERIN (MED, LMHC, CAP)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:ERIN
Last Name:HABRECHT-STASKO
Suffix:
Gender:F
Credentials:MED, LMHC, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4726 WADITA KA WAY
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33417-8015
Mailing Address - Country:US
Mailing Address - Phone:561-346-6641
Mailing Address - Fax:
Practice Address - Street 1:4726 WADITA KA WAY
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33417-8015
Practice Address - Country:US
Practice Address - Phone:561-346-6641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-27
Last Update Date:2010-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4204101YA0400X
FLMH9912101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)