Provider Demographics
NPI:1588154983
Name:RABAGO, ANDREA (LMFT)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:
Last Name:RABAGO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MS
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:CHARTIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:950 WESTBANK DR STE 104
Mailing Address - Street 2:
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-6689
Mailing Address - Country:US
Mailing Address - Phone:512-520-6480
Mailing Address - Fax:
Practice Address - Street 1:950 WESTBANK DR STE 104
Practice Address - Street 2:
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-6689
Practice Address - Country:US
Practice Address - Phone:512-520-6480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX202237106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist