Healthcare Provider Details

I. General information

NPI: 1063172039
Provider Name (Legal Business Name): ANDREA MORRIS LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANDREA LUCERO

II. Dates (important events)

Enumeration Date: 12/17/2021
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

172 N MAIN ST STE 1
SHERIDAN WY
82801-3922
US

IV. Provider business mailing address

542 RUNNING W DR
GILLETTE WY
82718-2074
US

V. Phone/Fax

Practice location:
  • Phone: 307-675-8840
  • Fax: 307-675-6378
Mailing address:
  • Phone: 307-257-2331
  • Fax: 307-670-8024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-2428
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: