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General NPI Number Information
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NPI Number | 1821112335
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Entity Type | Individual
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Provider Name | ALBERT G. ANDREWS LCPC
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Gender | Male
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 12/20/2023
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Provider Practice Location Address
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Address Line | 6805 STATE ROUTE 162 STE 201
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City | MARYVILLE
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State | IL
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Zip | 62062-8530
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Country | US
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Telephone | 618-288-5019
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Fax | 618-288-5059
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Provider Business Mailing Address
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Address Line | 6805 STATE ROUTE 162 STE 201
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City | MARYVILLE
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State | IL
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Zip | 62062-8530
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Country | US
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Telephone | 618-288-5019
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Fax | 618-288-5059
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 180-004678
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License Number State | IL
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