Provider Demographics
NPI:1891050555
Name:ADAMS, ANDREA LEIGH (LPC)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:LEIGH
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:ANDREA
Other - Middle Name:CANON
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:6881 ELM ST
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-4228
Mailing Address - Country:US
Mailing Address - Phone:469-667-8034
Mailing Address - Fax:
Practice Address - Street 1:6881 ELM ST
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-4228
Practice Address - Country:US
Practice Address - Phone:469-667-8034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-09
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17901101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1001Y00000XOtherBLUE CROSS BLUE SHIELD