Provider Demographics
NPI:1265611933
Name:ZEILBECK, ANDREW THOMAS (MASP)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:THOMAS
Last Name:ZEILBECK
Suffix:
Gender:M
Credentials:MASP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 PATTON ST
Mailing Address - Street 2:
Mailing Address - City:LA PORTE
Mailing Address - State:IN
Mailing Address - Zip Code:46350-3160
Mailing Address - Country:US
Mailing Address - Phone:219-575-1437
Mailing Address - Fax:219-362-1586
Practice Address - Street 1:109 PATTON ST
Practice Address - Street 2:
Practice Address - City:LA PORTE
Practice Address - State:IN
Practice Address - Zip Code:46350-3160
Practice Address - Country:US
Practice Address - Phone:219-575-1437
Practice Address - Fax:219-362-1586
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-30
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor