Provider Demographics
NPI:1336334317
Name:MARQUEZ, ANDEE NICOLE (PLMHP)
Entity Type:Individual
Prefix:MS
First Name:ANDEE
Middle Name:NICOLE
Last Name:MARQUEZ
Suffix:
Gender:F
Credentials:PLMHP
Other - Prefix:MS
Other - First Name:ANDEE
Other - Middle Name:NICOLE
Other - Last Name:HARDESTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC, LMHP, PLADC
Mailing Address - Street 1:1019 AVENUE N
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-3455
Mailing Address - Country:US
Mailing Address - Phone:402-540-6438
Mailing Address - Fax:
Practice Address - Street 1:4025 RAWLINS ST
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-1900
Practice Address - Country:US
Practice Address - Phone:307-426-4797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-12
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8444101YM0800X
NEP-754101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE96118OtherBCBS