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NPI Code Detail

MEDICARE: ANDREA LOFTIS LPC

MEDICARE: ANDREA LOFTIS LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2390200000XStudent in an Organized Health Care Education/Training Program
3101YM0800XMental Health Counselor7456OK

General Provider Information

NPI Number : 1639580848
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA LOFTIS LPC
Provider Business Mailing Address
First Line : 401 LISA ST APT 204
Second Line :
City : RINCON
State : GA
Zip : 31326-9602
Country : US
Telephone Number : 912-656-6007
Fax Number :
Provider Business Practice Location Address
First Line : 620 NW 5TH ST STE D
Second Line :
City : MOORE
State : OK
Zip : 73160-3947
Country : US
Telephone Number : 405-208-4469
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2014
Last Update Date : 01/11/2023

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