Provider Demographics
NPI:1700244126
Name:KAUFMAN, ANDREA (LPC, SLP)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:KAUFMAN
Suffix:
Gender:F
Credentials:LPC, SLP
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:KAUFMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ANDREA SIEGEL
Mailing Address - Street 1:3445 STRATFORD RD NE APT 2904
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30326-1721
Mailing Address - Country:US
Mailing Address - Phone:404-849-1174
Mailing Address - Fax:
Practice Address - Street 1:3445 STRATFORD RD NE APT 2904
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30326-1721
Practice Address - Country:US
Practice Address - Phone:404-849-1174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-29
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005675101YP2500X
GASLP000883235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional