MEDICARE: MR. VINCENT T ANDRUZZI I LPC-A

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
1	101YM0800X	Mental Health Counselor	89404	TX

General Provider Information

NPI Number	:	1750090817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. VINCENT T ANDRUZZI I LPC-A

Provider Business Mailing Address
First Line	:	7500 S-IH 35
Second Line	:	APT 133
City	:	AUSTIN
State	:	TX
Zip	:	78745-7874
Country	:	US
Telephone Number	:	512-364-0939
Fax Number	:

Provider Business Practice Location Address
First Line	:	7500 S-IH 35
Second Line	:	APT 133
City	:	AUSTIN
State	:	TX
Zip	:	78745-7874
Country	:	US
Telephone Number	:	512-364-0939
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2022
Last Update Date	:	11/17/2022

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