Provider Demographics
NPI:1669956686
Name:RICE, ANDREA KAYE (LPC)
Entity type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:KAYE
Last Name:RICE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1809 E SHERMAN AVE
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-5873
Mailing Address - Country:US
Mailing Address - Phone:208-665-9612
Mailing Address - Fax:208-635-0473
Practice Address - Street 1:1809 E SHERMAN AVE
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-5873
Practice Address - Country:US
Practice Address - Phone:208-665-9612
Practice Address - Fax:208-635-0473
Is Sole Proprietor?:No
Enumeration Date:2018-09-17
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC-7054101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional