Provider Demographics
NPI:1821112335
Name:ANDREWS, ALBERT G (LCPC)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:G
Last Name:ANDREWS
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6805 STATE ROUTE 162 STE 201
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62062-8530
Mailing Address - Country:US
Mailing Address - Phone:618-288-5019
Mailing Address - Fax:618-288-5059
Practice Address - Street 1:6805 STATE ROUTE 162 STE 201
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62062-8530
Practice Address - Country:US
Practice Address - Phone:618-288-5019
Practice Address - Fax:618-288-5059
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-004678101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health