Provider Demographics
NPI:1487108858
Name:SCHROEDER, ANDREA R (LPCC)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:R
Last Name:SCHROEDER
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:S
Other - Last Name:RUDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:670 CLEVELAND AVE S
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55116-1218
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:670 CLEVELAND AVE S
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55116-1218
Practice Address - Country:US
Practice Address - Phone:763-913-8261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-15
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6902-125101YP2500X
MN02513101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional