Provider Demographics
NPI:1245761113
Name:URBANEK, ANDREA JEANNINE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:JEANNINE
Last Name:URBANEK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:JEANNINE
Other - Last Name:PATTERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:4600 N MAYS ST APT 1442
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-1528
Mailing Address - Country:US
Mailing Address - Phone:737-786-1044
Mailing Address - Fax:
Practice Address - Street 1:1516 E PALM VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-4619
Practice Address - Country:US
Practice Address - Phone:512-402-3037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-23
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX589331041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker