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NPI Code Detail

MEDICARE: MRS. ANDREA ERIN HABRECHT-STASKO M.ED, LMHC, CAP

MEDICARE:  MRS. ANDREA ERIN HABRECHT-STASKO  M.ED, LMHC, CAP
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
1101YA0400XAddiction (Substance Use Disorder) Counselor4204FL
2101YM0800XMental Health CounselorMH9912FL

General Provider Information

NPI Number : 1760707202
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ANDREA ERIN HABRECHT-STASKO M.ED, LMHC, CAP
Provider Business Mailing Address
First Line : 4726 WADITA KA WAY
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33417-8015
Country : US
Telephone Number : 561-346-6641
Fax Number :
Provider Business Practice Location Address
First Line : 4726 WADITA KA WAY
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33417-8015
Country : US
Telephone Number : 561-346-6641
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2010
Last Update Date : 03/27/2010

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