Provider Demographics
NPI:1851910194
Name:WANG, ANDREA (LPCC)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 S YELLOWSTONE DR APT 102
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-4382
Mailing Address - Country:US
Mailing Address - Phone:408-343-9876
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 659
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03802-0659
Practice Address - Country:US
Practice Address - Phone:888-846-4821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-15
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA7989101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health