Provider Demographics
NPI:1851818272
Name:BREINER, ANDREA (MA, LPC, NCC, LAC)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:BREINER
Suffix:
Gender:F
Credentials:MA, LPC, NCC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 W TOMICHI AVE STE 201-C
Mailing Address - Street 2:
Mailing Address - City:GUNNISON
Mailing Address - State:CO
Mailing Address - Zip Code:81230-2323
Mailing Address - Country:US
Mailing Address - Phone:970-784-6460
Mailing Address - Fax:
Practice Address - Street 1:103 W TOMICHI AVE STE 201-C
Practice Address - Street 2:
Practice Address - City:GUNNISON
Practice Address - State:CO
Practice Address - Zip Code:81230-2323
Practice Address - Country:US
Practice Address - Phone:970-784-6460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-25
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0018859101YM0800X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health