Provider Demographics
NPI:1528167525
Name:MICHAEL, ANDREA (LCSW LMFT)
Entity type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:
Last Name:MICHAEL
Suffix:
Gender:F
Credentials:LCSW LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3355 BEE CAVES RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746
Mailing Address - Country:US
Mailing Address - Phone:512-328-2741
Mailing Address - Fax:512-327-8797
Practice Address - Street 1:3355 BEE CAVES RD
Practice Address - Street 2:SUITE 104
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746
Practice Address - Country:US
Practice Address - Phone:512-328-2741
Practice Address - Fax:512-327-8797
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX03994101YM0800X
TX3806106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00569FMedicaid