Provider Demographics
NPI:1245435205
Name:ANDREA BIEBERICH, PH.D., LP, PLLC
Entity type:Organization
Organization Name:ANDREA BIEBERICH, PH.D., LP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:BIEBERICH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:512-627-6259
Mailing Address - Street 1:5000 BEE CAVES RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5266
Mailing Address - Country:US
Mailing Address - Phone:512-627-6259
Mailing Address - Fax:
Practice Address - Street 1:5000 BEE CAVES RD
Practice Address - Street 2:SUITE 100
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-5266
Practice Address - Country:US
Practice Address - Phone:512-627-6259
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-19
Last Update Date:2014-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4190103TC0700X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty