Provider Demographics
NPI:1033477021
Name:KLOBUCHAR, ANDREA JOY (LPCC)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:JOY
Last Name:KLOBUCHAR
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:LYNN
Other - Last Name:ENGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:102 W BEATON DR STE 103
Mailing Address - Street 2:
Mailing Address - City:WEST FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58078-2653
Mailing Address - Country:US
Mailing Address - Phone:701-730-8313
Mailing Address - Fax:701-552-7975
Practice Address - Street 1:102 W BEATON DR STE 103
Practice Address - Street 2:
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078-2653
Practice Address - Country:US
Practice Address - Phone:701-730-8313
Practice Address - Fax:701-552-7975
Is Sole Proprietor?:No
Enumeration Date:2012-04-26
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND70010111A101Y00000X
ND70010111283101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor