Provider Demographics
NPI:1477252351
Name:MCIVER HERNANDEZ, DEANDREA RENE' (LPC)
Entity type:Individual
Prefix:
First Name:DEANDREA
Middle Name:RENE'
Last Name:MCIVER HERNANDEZ
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:DEANDREA
Other - Middle Name:RENE'
Other - Last Name:MCIVER HERNANDEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:1089 DOWNSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:ROBINSON
Mailing Address - State:TX
Mailing Address - Zip Code:76706-7195
Mailing Address - Country:US
Mailing Address - Phone:720-772-8111
Mailing Address - Fax:
Practice Address - Street 1:1089 DOWNSVILLE RD
Practice Address - Street 2:
Practice Address - City:ROBINSON
Practice Address - State:TX
Practice Address - Zip Code:76706-7195
Practice Address - Country:US
Practice Address - Phone:720-772-8111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-28
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0022095101YP2500X
CO0020457101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor