Provider Demographics
NPI:1407949324
Name:ZUFLACHT-CUKJATI, ANDREA LOUISE (LPC)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:LOUISE
Last Name:ZUFLACHT-CUKJATI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:ANDREA
Other - Middle Name:L
Other - Last Name:ZUFLACHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:9500 TIOGA DR
Mailing Address - Street 2:STE A
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-3118
Mailing Address - Country:US
Mailing Address - Phone:210-616-0828
Mailing Address - Fax:855-616-0829
Practice Address - Street 1:9500 TIOGA DR
Practice Address - Street 2:STE A
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-3118
Practice Address - Country:US
Practice Address - Phone:210-616-0828
Practice Address - Fax:855-616-0829
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17496101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX162024703Medicaid