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NPI Code Detail

MEDICARE: ANDREA JENAE HAUBERT

MEDICARE: ANDREA JENAE HAUBERT
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
1101YP2500XProfessional CounselorLPC20548SD

General Provider Information

NPI Number : 1932773637
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA JENAE HAUBERT
Provider Business Mailing Address
First Line : 2709 W 26TH ST
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57105-2305
Country : US
Telephone Number : 605-251-7424
Fax Number :
Provider Business Practice Location Address
First Line : 310 S 1ST AVE
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57104-6329
Country : US
Telephone Number : 605-336-2556
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2021
Last Update Date : 05/17/2021

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