Provider Demographics
NPI:1992386593
Name:ANDREA VANESTENBERG PD.D LLC
Entity Type:Organization
Organization Name:ANDREA VANESTENBERG PD.D LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:VANESTENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:724-691-0363
Mailing Address - Street 1:4000 HEMPFIELD PLAZA BLVD STE 916
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-2418
Mailing Address - Country:US
Mailing Address - Phone:724-691-0363
Mailing Address - Fax:724-237-4771
Practice Address - Street 1:4000 HEMPFIELD PLAZA BLVD STE 916
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-2418
Practice Address - Country:US
Practice Address - Phone:724-691-0363
Practice Address - Fax:724-237-4771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-16
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty